The Value of Phenobarbital in the Child Who Has Had a Single Febrile Seizure: A Controlled Prospective Study

PEDIATRICS ◽  
1977 ◽  
Vol 59 (3) ◽  
pp. 378-385 ◽  
Author(s):  
Sheldon M. Wolf ◽  
Andrew Carr ◽  
David C. Davis ◽  
Sherwood Davidson ◽  
Earle P. Dale ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Febrile Seizure ◽  
Febrile Convulsion ◽  
Febrile Seizures ◽  
The Other ◽  
Treatment Groups ◽  
Parental Resistance ◽  
Significant Difference ◽  
The Mean

A group of 355 children who were seen after a first febrile convulsion at the Kaiser Foundation Hospitals in Southern California from 1970 to 1975 were randomly assigned to three treatment groups—daily phenobarbital, "intermittent" phenobarbital given at the onset of fever, and no phenobarbital. We found that 42% had a relative with a febrile seizure and 16% a relative with an afebrile convulsion. 13% had seizures which were either lateralized or longer than ten minutes. Parents were unaware of the fever prior to the seizure in about 30% of the cases. In 81% the preseizure duration of fever was less than 24 hours. The mean follow-up was 28 months, with a range of 6 to 70 months. There was no significant difference in the recurrence rate between children receiving "intermittent" as compared with no phenobarbital. The recurrence rate in children receiving daily phenobarbital was significantly decreased compared to either of the other two groups. Severe recurrent febrile seizures occurred in no children on daily phenobarbital and in 4.4% of the children receiving either intermittent or no phenobarbital. Parental resistance, compliance, and reversible hyperactivity were the main problems encountered with the continuous phenobarbital regimen.

scholarly journals Functional and radiographical results of asymmetrically reconstructed total hip arthroplasty in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other Crowe IV: a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Junmin Shen ◽  
Jingyang Sun ◽  
Yinqiao Du ◽  
Bohan Zhang ◽  
Tiejian Li ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
The Other ◽  
Anatomical Reconstruction ◽  
Center Of Rotation ◽  
Total Hip ◽  
Anatomical Position ◽  
Significant Difference ◽  
The Mean

Abstract Background The study aimed to evaluate the functional and radiographical results of asymmetrically reconstructed total hip arthroplasty in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other hip Crowe IV. Materials and methods From April 2006 to April 2019, we evaluated 23 patients who had a reconstruction of one Crowe II–III hip with high hip center (HHC) and the other Crowe IV hip at the anatomical position (H group). The radiographic and clinical outcomes were compared with those of a control group of 19 patients with bilateral dysplasia who had one Crowe IV hip and the contralateral hip both reconstructed in the anatomical position (A group). Medical records and radiographs were reviewed, and a complete follow-up was conducted for all patients. Results The mean vertical center of rotation (V-COR) and horizontal center of rotation (H-COR) in the H group were 30.6 ± 5.8 mm and 30.0 ± 5.5 mm, respectively. In the A group, the corresponding values were 14.0 ± 4.3 mm and 23.0 ± 2.3 mm, respectively. A significant difference was found in terms of V-COR and H-COR between the two groups, and no significant difference was shown regarding the cup inclination, abductor lever arm (ALA), ALA ratio, and leg length discrepancy (LLD). Three patients of the H group and four patients of the A group exhibited LLD > 10 mm. All seven patients who had LLD > 10 mm underwent the shortening subtrochanteric osteotomy (SSTO) of the Crowe IV hip. Subgroup analysis based on the presence and absence of SSTO showed that the LLD of the SSTO group was greater than that of the non-SSTO group in both groups, but the difference was only statistically significant in the A group. At the last follow-up, the mean Harris Hip Scores significantly improved in the two groups, and there was no revision during the follow-up period. In the H group, four patients presented with a slight limp and three patients with a moderate limp, while it was six patients and one patient in the A group, respectively. Conclusions Asymmetrical reconstruction in patients with bilateral dysplastic arthritic hips with one hip Crowe II–III and the other Crowe IV is acceptable and comparable when compared with bilateral anatomical reconstruction. Level of evidence III, retrospective observational study. Trial registration Chinese Clinical Trail Registry. ChiCTR2000033848

Effect of Metatarsus Adductus on Hallux Valgus Treated With Proximal Reverse Chevron Metatarsal Osteotomy

2021 ◽  
pp. 107110072199036
Author(s):  
Seung-Myung Choi ◽  
Jong-Soo Lee ◽  
Jung-Won Lim ◽  
Je-Min Im ◽  
Duk-Hwan Kho ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hallux Valgus ◽  
Recurrence Rate ◽  
Metatarsal Osteotomy ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Metatarsus Adductus ◽  
The Mean

Background: This study aimed to compare clinical and radiographic outcomes and recurrence rates after reverse proximal chevron metatarsal osteotomy (PCMO) for patients with hallux valgus (HV) with or without metatarsus adductus (MA). We hypothesized that patients with MA would have poorer outcomes and a higher radiographic recurrence rate than those without MA. Methods: This retrospective single-surgeon series comprised 144 patients (173 feet) with moderate to severe HV, treated with PCMO and Akin osteotomy without lesser metatarsal procedures, who were grouped according to the presence (MA group) or absence of MA (non-MA group). Clinical assessment included the American Orthopaedic Foot & Ankle Society (AOFAS) score, pain visual analog scale (VAS), and patient satisfaction rating. Radiographic assessments included metatarsus adductus angle (MAA), HV angle (HVA), and intermetatarsal angle (IMA). Results: The prevalence of the MA was 24.2%. The mean MAA was 23.1 ± 3.3 degrees in the MA group. There were no differences in the mean AOFAS score and pain VAS score at the final follow-up between the 2 groups (all P > .05). The patient satisfaction rate was 73.8% in the MA group vs 90.1% in the non-MA group ( P = .017). The mean postoperative HVA and IMA significantly improved at the final follow-up in both groups, respectively (all P < .001). Preoperative and postoperative HVA were larger in the MA group vs non-MA group. However, no significant difference was found in the improvement of HVA and IMA after surgery between the 2 groups (all P > .05). The recurrence rate was 28.6% in the MA group and 6.1% in the non-MA group ( P < .001). Conclusion: HV patients associated with the MA had a higher degree of preoperative HV, lower correction of the HVA, higher radiographic recurrence rate, and poorer patient satisfaction than those without MA post-PCMO without lesser metatarsal procedures. Therefore, a more extensive HV correction procedure or the addition of a lesser metatarsal realignment procedure may need to be considered. Level of Evidence: Level III, retrospective comparative series.

scholarly journals Efficacy of intermittent prophylaxis vis a vis no prophylactic interventions in febrile seizure recurrence: randomised controlled trail

2019 ◽  
Vol 7 (11) ◽  
pp. 4064
Author(s):  
Nitin Bhoyar ◽  
Baraturam Bhaisara ◽  
Dinesh Kumar Singh
Keyword(s):  
Recurrence Rate ◽  
Febrile Seizure ◽  
Febrile Seizures ◽  
Care Hospital ◽  
Chi Square ◽  
Chi Square Test ◽  
History Of ◽  
Group A ◽  
Febrile Episodes

Background: To compare efficacy of intermittent prophylaxis during subsequent febrile episodes with antipyretics alone or antipyretics with anticonvulsant (clobazam) vis a vis no prophylactic interventions except need-based antipyretic measures in preventing recurrence of febrile seizures.Methods: This prospective randomized controlled interventional study was carried out in neurologically normal children. Study conducted over 14 months (March 2014 - May 2015), tertiary care hospital Mumbai. Inclusion criteria was, children aged from 6 month to 5 years with history of simple febrile seizure, lasting for less than 15 minutes, with Frequency less than one episode in 24 hours. Children with history of afebrile or complex febrile seizure, CNS comorbidity, family history of epilepsy, abnormal electroencephalogram, Unwillingness or non-feasibility of follow up were excluded from study. The patients were randomly grouped in A (No Prophylaxis n= 60), B (Antipyretic prophylaxis n=57) and C (Antipyretics + clobazam prophylaxis n=55). All cases were followed up telephonically every 15 days from date of first seizure as well as personal follow up at 1,3,6 months either in the hospital or at home. End point of study was taken as six months of follow-up from enrolment or lost-to-follow up. Efficacy of intervention was compared using chi-square test, Pearson chi-square test with/without Yates continuity correction and/or Fisher exact test, with p value of <0.05 as test of significance.Results: Sixty cases in group A developed febrile episodes and 6 of them developed recurrence of febrile seizures, with a recurrence rate of 10% among total cases and 9.67% among all febrile episodes. Recurrence rate was significantly higher (10%) in cases who did not receive any prophylactic intervention (Group A) as compared to pooled recurrence rate in group B and C together 1.78% (p=0.022).Conclusion: Regular antipyretic prophylaxis, alone or along with clobazam does not reduce the risk of recurrence in simple febrile seizures as compared to those who receive antipyretic intervention.

scholarly journals Sex differences in Sport-related Concussion in Japan

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S3.3-S4
Author(s):  
Haruo Nakayama ◽  
Yu Hiramoto ◽  
Satoshi Fujita ◽  
Sho Sato ◽  
Ryo Suzuki ◽  
...  
Keyword(s):  
Sex Differences ◽  
Head Injury ◽  
Medical Center ◽  
The Other ◽  
Female Group ◽  
Inclusion Criteria ◽  
Male And Female ◽  
Significant Difference ◽  
The Mean

ObjectiveTo evaluate the Sex differences in Sport-related Concussion in Japan.BackgroundWe dont't have the knowledge about the sex differences in SRC in Japan.Design/MethodsThe study design was retrospective study. Facility is Toho University Ohashi Medical Center Neurosurgery Sports-related head injury clinic. The search period is April 2017 to February 2018. Inclusion criteria were as follows: 1) Sports-related head injury cases, 2) Physician-diagnosed Sports-related concussion, 3) Underwent evaluation by the same neurosurgeon, 4) More than 28 days continued follow-up. The following items were compared male and female. The examination items were as follows: 1) Age/sex, 2) competition item, 3) prior concussion, 4) Migraine history, 5) persistent post concussive symptoms. Statistical analysis used t test.ResultsThe 140 selected cases were 114 male (Group M: GM) and 26 female (Group F: GF). The mean Age of both GM and GF was 20 years. The most majority competition item of GM was Rugby football. On the other hand, GF was lacrosse. 42 cases of GM and 9 cases of GF suffered prior concussion (p > 0.05, no significant). 19 cases of GM and 6 cases of GF had migraine history (p > 0.05, no significant). 37 cases of GM and 16 cases of GF had PPCS (p < 0.05).ConclusionsOur result suggests that female players explain the significant difference in the prevalence of PPCS in Japan.

Multi-Center Study of Thromboplastin Calibration Precision – Influence of Reagent Species, Composition, and International Sensitivity Index (ISI)

1993 ◽  
Vol 69 (01) ◽  
pp. 035-040 ◽  
Author(s):  
A M H P van den Besselaar ◽  
R M Bertina
Keyword(s):  
Oral Anticoagulants ◽  
International Normalized Ratio ◽  
The Other ◽  
World Health ◽  
Rabbit Brain ◽  
Sensitivity Index ◽  
Bovine Plasma ◽  
Significant Difference ◽  
The Mean ◽  
International Sensitivity Index

SummaryFour thromboplastin reagents were tested by 18 laboratories in Europe, North-America, and Australasia, according to a detailed protocol. One thromboplastin was the International Reference Preparation for ox brain thromboplastin combined with adsorbed bovine plasma (coded OBT/79), and the second was a certified reference material for rabbit brain thromboplastin, plain (coded CRM 149R). The other two thromboplastin reagents were another rabbit plain brain thromboplastin (RP) with a lower ISI than CRM 149R and a rabbit brain thromboplastin combined with adsorbed bovine plasma (RC). Calibration of the latter two reagents was performed according to methods recommended by the World Health Organization (W. H. O.).The purpose of this study was to answer the following questions: 1) Is the calibration of the RC reagent more precise against the bovine/combined (OBT/79) than against the rabbit/plain reagent (CRM 149R)? 2) Is the precision of calibration influenced by the magnitude of the International Sensitivity Index (ISI)?The lowest inter-laboratory variation of ISI was observed in the calibration of the rabbit/plain reagent (RP) against the other rabbit/plain reagent (CRM 149R) (CV 1.6%). The highest interlaboratory variation was obtained in the calibration of rabbit/plain (RP) against bovine/combined (OBT/79) (CV 5.1%). In the calibration of the rabbit/combined (RC) reagent, there was no difference in precision between OBT/79 (CV 4.3%) and CRM 149R (CV 4.2%). Furthermore, there was no significant difference in the precision of the ISI of RC obtained with CRM 149R (ISI = 1.343) and the rabbit/plain (RP) reagent with ISI = 1.14. In conclusion, the calibration of RC could be performed with similar precision with either OBT/79 or CRM 149R, or RP.The mean ISI values calculated with OBT/79 and CRM 149R were practically identical, indicating that there is no bias in the ISI of these reference preparations and that these reference preparations have been stable since their original calibration studies in 1979 and 1987, respectively.International Normalized Ratio (INR) equivalents were calculated for a lyophilized control plasma derived from patients treated with oral anticoagulants. There were small but significant differences in the mean INR equivalents between the bovine and rabbit thromboplastins. There were no differences in the interlaboratory variation of the INR equivalents, when the four thromboplastins were compared.

scholarly journals Association of biological antirheumatic therapy with risk for type 2 diabetes: a retrospective cohort study in incident rheumatoid arthritis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042246
Author(s):  
Sanjoy K Paul ◽  
Olga Montvida ◽  
Jennie H Best ◽  
Sara Gale ◽  
Attila Pethö-Schramm ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Type 2 Diabetes ◽  
T Cell ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Therapy ◽  
Treatment Groups ◽  
Significant Difference ◽  
Necrosis Factor

ObjectiveTo explore possible associations of treatment with biological disease-modifying antirheumatic drugs (bDMARDs), including T-cell-based and interleukin-6 inhibition (IL-6i)-based therapies, and the risk for type 2 diabetes mellitus (T2DM) in patients with rheumatoid arthritis (RA).Study design, setting and participantsFive treatment groups were selected from a United States Electronic Medical Records database of 283 756 patients with RA (mean follow-up, 5 years): never received bDMARD (No bDMARD, n=125 337), tumour necrosis factor inhibitors (TNFi, n=34 873), IL-6i (n=1884), T-cell inhibitors (n=5935) and IL-6i+T cell inhibitor abatacept (n=1213). Probability and risk for T2DM were estimated with adjustment for relevant confounders.ResultsIn the cohort of 169 242 patients with a mean 4.5 years of follow-up and a mean 641 200 person years of follow-up, the adjusted probability of developing T2DM was significantly lower in the IL-6i (probability, 1%; 95% CI 0.6 to 2.0), T-cell inhibitor (probability, 3%; 95% CI 2.3 to 3.3) and IL-6i+T cell inhibitor (probability, 2%; 95% CI 0.1 to 2.9) groups than in the No bDMARD (probability, 5%; 95% CI 4.6 to 4.9) and TNFi (probability, 4%; 95% CI 3.7 to 4.7) groups. Compared with No bDMARD, the IL-6i and IL-6i+T cell inhibitor groups had 37% (95% CI of HR 0.42 to 0.96) and 34% (95% CI of HR 0.46 to 0.93) significantly lower risk for T2DM, respectively; there was no significant difference in risk in the TNFi (HR 0.99; 95% CI 0.93 to 1.06) and T-cell inhibitor (HR 0.96; 95% CI 0.82 to 1.12) groups.ConclusionsTreatment with IL-6i, with or without T-cell inhibitors, was associated with reduced risk for T2DM compared with TNFi or No bDMARDs; a less pronounced association was observed for the T-cell inhibitor abatacept.

scholarly journals THU0517 THE ROLE OF ULTRASOUND-DEFINED SYNOVITIS GRADE I IN PATIENTS PRESENTING WITH INFLAMMATORY ARTHRALGIA, A RETROSPECTIVE STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 497.2-497
Author(s):  
J. Arroyo Palomo ◽  
M. Arce Benavente ◽  
C. Pijoan Moratalla ◽  
B. A. Blanco Cáceres ◽  
A. Rodriguez
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Arthritis ◽  
Statistical Tests ◽  
Median Number ◽  
Painful Joint ◽  
Significant Difference ◽  
The Mean ◽  
Specialized Unit

Background:Musculoeskeletal ultrasound (MSUS) is frequently used in several rheumatology units to detect subclinical inflammation in patients with joint symptoms suspected for progression to inflammatory arthritis (IA). Synovitis grade I (EULAR-OMERACT combined score) is known to be a casual finding in healthy individuals, but studies headed to unravel its possible role on rheumatic diseases are sparse.Objectives:To investigate the correlation between synovitis grade I, and the diagnosis of IA made after a year follow-up period since MSUS findings, in patients of an MSUS-specialized unit of a Rheumatology Department.Methods:We conducted a descriptive, retrospective and unicentric study. 30 patients were selected from the MSUS-specialized unit of our Rheumatology Department from July-18 to January-19. Patients presenting synovitis grade 0 (exclusively), 2 and/or 3 on combined score were excluded. Data collection at baseline included age, sex, immunological profile and previous physical examination to the MSUS findings, as well as the diagnosis made by the rheumatologist in 1-year visit follow-up: dividing the patient sample into two groups: those who were diagnosed with IA and those not. Non-parametric statistical tests for comparing means were used.Results:The mean age was 51,6 years and 70% were females. 6 (20%) patients were diagnosed with inflammatory arthritis after a year follow-up: 2 (4,8%) psoriatic arthritis, 1 (3,3%) undifferentiated arthritis, 1 (3,3%) rheumatoid arthritis, 1 (3,3%) Sjögren’s syndrome. Non-inflammatory arthropathies were also found 24 (80%), of which, 12 (40%) were non-specific arthralgias and 8 (19%) osteoarthritis.In the group of patients who did not developed an IA the mean C-reactive protein (CPR) value was 3,12 mg/L and erythrocyte sedimentation rate (ESR) was 8,2 mm; all of them were rheumatoid factor (RF) positive and ACPA-negative except one patient. 5 (31,3%) patients presented low antinuclear antibodies (ANAs) levels. In those who HLA B-27 and Cw6 were tested (4,25%); both were negative except for one that was HLA B-27 positive. The median number of swollen and painful joint count was 0, and the mean of joints with MSUS involvement was 3,5; the mean involved metacarpophalangeal (MCP) joints was 1,83; proximal interphalangeal (PIP) joints was 1,48 and distal interphalangeal (DIP) joints 0,21.Among the group of patients that developed an IA the mean of CPR and ESR was 9,27 mg/L and 14,17 mm respectively; 2 (33%) patients were RF- positive, and 1 ACPA-positive. ANAs were positive in 3 cases (50%). The median of swollen joint count was 2 and for painful joint count was 0, the median of joints with MSUS involvement was 4,5. The mean of MSUS involvement was for MCP, PIP and DIP joints: 1,67, 2 and 0. Comparing the means of CPR values in the two groups with Student’s t-test we obtained a statistically significant difference (p=0,023). No other significant differences were found.Conclusion:Despite the limitations and possible statistical bias, the presence of MSUS-defined synovitis grade I and elevated CRP levels could be related to further diagnoses of inflammatory arthropathy. Besides, the absence of synovitis in DIP joints might have a diagnostic role. Normal physical exploration and normal levels of CRP might suggest low MSUS value. However, further research is needed to clarify the role of MSUS-defined synovitis grade I.References:[1]D’Agostino MA et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardized, consensus-based scoring system. RMD Open. 2017;3(1):e000428.[2]Van den Berg R et al. What is the value of musculoskeletal ultrasound in patients presenting with arthralgia to predict inflammatory arthritis development? A systematic literature review. Arthritis Research & Therapy (2018) 20:228.Disclosure of Interests:None declared

scholarly journals Importance of a Follow-Up Ultrasound Protocol in Monitoring Posttraumatic Spleen Complications in Children Treated with a Non-Operative Management

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 734
Author(s):  
Ivona Djordjevic ◽  
Dragoljub Zivanovic ◽  
Ivana Budic ◽  
Ana Kostic ◽  
Danijela Djeric
Keyword(s):  
Splenic Abscess ◽  
Operative Management ◽  
High Energy ◽  
Significant Difference ◽  
Injury Grade ◽  
Grade Ii ◽  
The Mean ◽  
Non Operative Management ◽  
Grade Iii

Background and objectives: For the last three decades, non-operative management (NOM) has been the standard in the treatment of clinically stable patients with blunt spleen injury, with a success rate of up to 95%. However, there are no prospective issues in the literature dealing with the incidence and type of splenic complications after NOM. Materials and methods: This study analyzed 76 pediatric patients, up to the age of 18, with blunt splenic injury who were treated non-operatively. All patients were included in a posttraumatic follow-up protocol with ultrasound examinations 4 and 12 weeks after injury. Results: The mean age of the children was 9.58 ± 3.97 years (range 1.98 to 17.75 years), with no statistically significant difference between the genders. The severity of the injury was determined according to the American Association for Surgery of Trauma (AAST) classification: 7 patients had grade I injuries (89.21%), 21 patients had grade II injuries (27.63%), 33 patients had grade III injuries (43.42%), and 15 patients had grade IV injuries (19.73%). The majority of the injuries were so-called high-energy ones, which were recorded in 45 patients (59.21%). According to a previously created posttraumatic follow-up protocol, complications were detected in 16 patients (21.05%). Hematomas had the highest incidence and were detected in 11 patients (14.47%), while pseudocysts were detected in 3 (3.94%), and a splenic abscess and pseudoaneurysm were detected in 1 patient (1.31%), respectively. The complications were in a direct correlation with injury grade: seven occurred in patients with grade IV injuries (9.21%), five occurred in children with grade III injuries (6.57%), three occurred in patients with grade II injuries (3.94%), and one occurred in a patient with a grade I injury (1.31%). Conclusion: Based on the severity of the spleen injury, it is difficult to predict the further course of developing complications, but complications are more common in high-grade injuries. The implementation of a follow-up ultrasound protocol is mandatory in all patients with NOM of spleen injuries for the early detection of potentially dangerous and fatal complications.

Effectiveness of Virtual Resilience Training on Assertiveness in Student Girls Aged 9–10 Years: A 1-Month Follow-Up

2021 ◽  
pp. 105984052110135
Author(s):  
Shima Gadari ◽  
Jamile Farokhzadian ◽  
Parvin Mangolian Shahrbabaki
Keyword(s):  
Experimental Study ◽  
Internal Stress ◽  
Intervention Group ◽  
The Other ◽  
Hormonal Changes ◽  
Emotional Instability ◽  
Other Hand ◽  
Significant Difference ◽  
Resilience Training

Girls between the ages of 9 and 10 begin to experience physical, physiological, and hormonal changes that may lead to internal stress. At this age, children are struggling for autonomy; on the other hand, they may experience emotional instability, and for these reasons, they may be vulnerable in many ways. This experimental study aimed to investigate the effect of resilience training on assertiveness in student girls aged 9–10. Data were collected before, immediately after, and 1 month after the intervention in the control ( n = 40) and intervention ( n = 37) groups. There was a significant difference between the assertiveness of the intervention immediately (26.80 ± 3.73) and 1 month after the intervention (27.05 ± 3.73), and assertiveness significantly increased in the intervention group ( p = .0001). Resilience training leads to improvements in assertiveness in student girls aged 9–10.

Capsular closure versus unrepaired interportal capsulotomy after hip arthroscopy in patients with femoroacetabular impingement, results of a patient-blinded randomised controlled trial

2021 ◽  
pp. 112070002110057
Author(s):  
Niels H Bech ◽  
Inger N Sierevelt ◽  
Sheryl de Waard ◽  
Boudijn S H Joling ◽  
Gino M M J Kerkhoffs ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Controlled Trial ◽  
Poor Quality ◽  
Control Group ◽  
Treatment Groups ◽  
Significant Difference ◽  
Randomised Controlled

Background: Hip capsular management after hip arthroscopy remains a topic of debate. Most available current literature is of poor quality and are retrospective or cohort studies. As of today, no clear consensus exists on capsular management after hip arthroscopy. Purpose: To evaluate the effect of routine capsular closure versus unrepaired capsulotomy after interportal capsulotomy measured with NRS pain and the Copenhagen Hip and Groin Outcome Score (HAGOS). Materials and methods: All eligible patients with femoroacetabular impingement who opt for hip arthroscopy ( n = 116) were randomly assigned to one of both treatment groups and were operated by a single surgeon. Postoperative pain was measured with the NRS score weekly the first 12 weeks after surgery. The HAGOS questionnaire was measured at 12 and 52 weeks postoperatively. Results: Baseline characteristics and operation details were comparable between treatment groups. Regarding the NRS pain no significant difference was found between groups at any point the first 12 weeks after surgery ( p = 0.67). Both groups significantly improved after surgery ( p < 0.001). After 3 months follow-up there were no differences between groups for the HAGOS questionnaire except for the domain sport ( p = 0.02) in favour of the control group. After 12 months follow-up there were no differences between both treatment groups on all HAGOS domains ( p  > 0.05). Conclusions: The results of this randomised controlled trial show highest possible evidence that there is no reason for routinely capsular closure after interportal capsulotomy at the end of hip arthroscopy. Trial Registration: This trial was registered at the CCMO Dutch Trial Register: NL55669.048.15.

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