The effect of different knee joint exposures of TKR on the variability of gait parameters in early postoperative period

Aim: to evaluate the effects of intravenous dexamethasone on postoperative analgesia in patients after arthroscopic knee joint surgery in conditions of peripheral regional blockade. Material and methods: 60 patients were included in the study, divided into 2 groups. In the first group, patients underwent peripheral regional blockade of the femoral and sciatic nerves with a 0.5% solution of levobupivacaine. In the second, the traditional peripheral regional blockade was supplemented by intravenous administration of 8 mg (0.4% - 2 ml) of dexamethasone immediately after catarrhization of the peripheral vein. Results: The duration of the sensory blockade in the group using dexamethasone was 25% greater than in the first group. In the postoperative period, patients who were intraoperatively injected with dexamethasone required 33% less additional anesthesia. The duration of motor blockade in the group with dexamethasone was 26.5% higher than in the patients of the first group. Conclusion: intravenous dexamethasone injection with levobupivacaine peripheral regional anesthesia with arthroscopic knee joint surgery, increases the duration of the sensory block and the duration of postoperative analgesia. The use of dexamethasone led to a decrease in the need for additional anesthesia in the early postoperative period.

Download Full-text

Comparison of Spatiotemporal Gait Parameters Following Operative Treatment of Trimalleolar Ankle Fractures vs Healthy Controls

Foot & Ankle Orthopaedics ◽

10.1177/2473011420931052 ◽

2020 ◽

Vol 5 (3) ◽

pp. 247301142093105

Author(s):

Andrew F. Tyler ◽

Thomas Rose ◽

Scott Day ◽

Jessica Kenia ◽

Annamarie D. Horan ◽

...

Keyword(s):

Operative Treatment ◽

Postoperative Period ◽

Fracture Fixation ◽

Ankle Fracture ◽

Early Postoperative Period ◽

Ankle Fractures ◽

Gait Patterns ◽

Posterior Malleolus ◽

Gait Parameters ◽

Healthy Control

Background: Controversy continues regarding appropriate indications for posterior malleolus fracture fixation in unstable rotational trimalleolar ankle injuries, with limited data comparing gait in operatively treated trimalleolar ankle fractures vs control populations. The purpose of this study was to evaluate the effect of trimalleolar ankle fracture fixation on gait parameters in the early postoperative period as compared to a healthy control population. Methods: Adult patients having undergone operative treatment of isolated trimalleolar ankle fractures were eligible for inclusion. A total of 10 patients met the inclusion criteria and participated in the analysis. Patients were evaluated using standard parameters of human gait 6 months after their index procedures, with gait values compared to a population of 17 non–age-matched healthy control subjects in addition to literature values of healthy populations of younger and older subjects. Results: Significant differences were noted between the spatiotemporal gait parameters of healthy control subjects and patients who had undergone operative treatment of trimalleolar ankle fractures. However, within the fracture group itself, no differences were found between patients with or without posterior malleolar fixation for any of the tested gait parameters. When patients were compared to literature values of younger and older healthy control populations, they were found to have gait patterns more similar to older rather than younger individuals. Conclusion: Operative fixation of trimalleolar ankle fracture does not restore normal gait function in the early postoperative period. Fixation of the posterior malleolus in particular also does not appear to improve gait characteristics. Patients who undergo surgery for these injuries demonstrate gait patterns similar to those of healthy older adults. Level of Evidence: Level II, Therapeutic (prospective cohort study).

Download Full-text