COMPARATIVE ANALYSIS OF COMPLICATIONS IN PATIENTS AFTER INDIVIDUAL ONCOLOGICAL AND MODULAR ONCOLOGICAL ENDOPROSTHETICS OF THE KNEE JOINT WITH TUMOR LESIONS

2020 ◽  
Vol 119 (4) ◽  
pp. 7-13
Author(s):  
Олександр Бур’янов ◽  
Обада Муххамад Біштаві ◽  
Володимир Проценко
Keyword(s):  
Comparative Analysis ◽  
Knee Joint ◽  
Antibiotic Therapy ◽  
Bone Fracture ◽  
Infectious Complication ◽  
Bone Plates ◽  
Cement Spacer ◽  
Periprosthetic Bone ◽  
Total Endoprosthesis ◽  
Long Course

The article contains analysis of complications after individual oncological knee joint endoprosthesis replacement in cases of tumor lesions. Complications were observed in 45 ,8% of cases after knee joint endoprosthesis replacement operations with tumor lesions. The main complications that were observed included infectious ones: 18,1%, aseptic instability of the endoprosthesis stem:  16,7%, bone fracture at the site of endoprosthesis stem implantation: 6,9%, destruction of the endoprosthesis structure: 4,2%. The factors that led to complications, as well as methods of their elimination are given. Dialysis and a long course of antibiotic therapy or the installation of a metal-cement spacer device followed by repeated endoprosthesis replacement is advised in case of an infectious complication. Repeated joint endoprosthesis replacement with replacement of only one (loose) component of the endoprosthesis, using a long intramedullary stem or replacement of the total endoprosthesis is advised in case of aseptic instability of the endoprosthesis stem. Metallic osteosynthesis of the  periprosthetic bone fracture is performed using bone plates  and cable grip in cases of bone fracture at the site of endoprosthesis stem implantation. Repeated joint endoprosthesis replacement is effected with replacement of the entire endoprosthesis structure in case of destruction of the endoprosthesis structure.

scholarly journals COMPARATIVE ANALYSIS OF COMPLICATIONS IN PATIENTS AFTER INDIVIDUAL ONCOLOGICAL AND MODULAR ONCOLOGICAL ENDOPROSTHETICS OF THE KNEE JOINT WITH TUMOR LESIONS

2020 ◽  
Vol 119 (4) ◽  
pp. 14-24
Author(s):  
Oleksandr Buryanov ◽  
Obada Mohammad Bishtawi ◽  
Volodymyr Protsenko ◽  
Yevhen Solonitsyn
Keyword(s):  
Comparative Analysis ◽  
Knee Joint ◽  
Antibiotic Therapy ◽  
Bone Fracture ◽  
Infectious Complication ◽  
Bone Plates ◽  
Cement Spacer ◽  
Periprosthetic Bone ◽  
Total Endoprosthesis ◽  
Long Course

The article contains analysis of complications after individual oncological knee joint endoprosthesis replacement in cases of tumor lesions. Complications were observed in 45 ,8% of cases after knee joint endoprosthesis replacement operations with tumor lesions. The main complications that were observed included infectious ones: 18,1%, aseptic instability of the endoprosthesis stem:  16,7%, bone fracture at the site of endoprosthesis stem implantation: 6,9%, destruction of the endoprosthesis structure: 4,2%. The factors that led to complications, as well as methods of their elimination are given. Dialysis and a long course of antibiotic therapy or the installation of a metal-cement spacer device followed by repeated endoprosthesis replacement is advised in case of an infectious complication. Repeated joint endoprosthesis replacement with replacement of only one (loose) component of the endoprosthesis, using a long intramedullary stem or replacement of the total endoprosthesis is advised in case of aseptic instability of the endoprosthesis stem. Metallic osteosynthesis of the  periprosthetic bone fracture is performed using bone plates  and cable grip in cases of bone fracture at the site of endoprosthesis stem implantation. Repeated joint endoprosthesis replacement is effected with replacement of the entire endoprosthesis structure in case of destruction of the endoprosthesis structure.

scholarly journals ENDOPROSTHETIC REPLACEMENTIN PATIENTS WITH TUMORS OF BONES AND JOINTS: REVISION SURGERY

2021 ◽  
Vol 11 (1) ◽  
pp. 66-72
Author(s):  
Volodymyr Protsenko ◽  
Olexandr Burianov ◽  
Obada Bishtawi ◽  
Yevgen Solonitsyn
Keyword(s):  
Knee Joint ◽  
Hip Joint ◽  
Intramedullary Nail ◽  
Revision Surgery ◽  
Elbow Joint ◽  
Infectious Complication ◽  
Periprosthetic Infection ◽  
Cement Spacer ◽  
Tibial Shaft ◽  
Revision Operations

The article analyzes complications after individual oncological endoprosthesis replacement in tumor lesions of bones and joints, which led to repeated endoprosthesis replacement. After operations of endoprosthesis replacement of bones and joints with tumor lesions, the following complications were observed: periprosthetic infection — 7.4%, aseptic instability of the stem of endoprosthesis —13.1%, destruction of the endoprosthesis structure - 2.3%, wear of polyethylene inserts — 1.7%. Revision endoprosthesis replacement due to complications after endoprosthesis replacement of bones and joints for tumors was performed in 38 (21.7%) cases. Repeated endoprosthesis replacement of knee joint was performed in 22 cases, repeated endoprosthesis replacement of hip joint was performed in 6 cases, repeated endoprosthesis replacement of elbow joint was performed in 4 cases, repeated endoprosthesis replacement of shoulder joint was performed in 3 cases, repeated endoprosthesis replacement of tibial shaft was performed in 2 cases, repeated endoprosthesis replacement of ankle joint was performed in 1 case. The factors that led to complications and repeated endoprosthesis replacement were presented. In case of an infectious complication, it was recommended to install a metal-on-cement spacer, followed by repeated endoprosthesis replacement; in case of aseptic instability of the stem of endoprosthesis, repeated endoprosthesis replacement was performed with replacement of only one (loose) component of the endoprosthesis using a long intramedullary nail or replacement of the entire endoprosthesis; in case of the destruction of endoprosthesis structure, the repeated endoprosthesis replacement of the joint was effected with replacement of the entire endoprosthesis structure; when the polyethylene inserts were worn out, the repeated endoprosthesis replacement was performed with the replacement of the polyethylene inserts. After repeated endoprosthesis replacement, repeated revision operations were performed in 10 (26.3%) cases.

Effectiveness and Safety of Short-Course vs Long-Course Antibiotic Therapy for Group A β-Hemolytic Streptococcal Tonsillopharyngitis: A Meta-analysis of Randomized Trials

2008 ◽  
Vol 83 (8) ◽  
pp. 880-889 ◽  
Author(s):  
Matthew E. Falagas ◽  
Evridiki K. Vouloumanou ◽  
Dimitrios K. Matthaiou ◽  
Anastasios M. Kapaskelis ◽  
Drosos E. Karageorgopoulos
Keyword(s):  
Antibiotic Therapy ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Short Course ◽  
Group A ◽  
Long Course

scholarly journals Comparative Analysis of Knee Joint Fusion with Long Locking Nail and Ilizarov Apparatus in Patients with Deep Infection after Arthroplasty

2020 ◽  
Vol 26 (3) ◽  
pp. 109-118
Author(s):  
L. N. Solomin ◽  
E. A. Shchepkina ◽  
K. L. Korchagin ◽  
F. K. Sabirov
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Blood Loss ◽  
Knee Joint ◽  
Internal Fixation ◽  
Inpatient Treatment ◽  
Deep Infection ◽  
Knee Arthrodesis ◽  
Locking Nail

Relevance. Deep infection after knee arthroplasty requires radical surgical treatment of the infection site, removal of endoprosthesis components, and an antimicrobial spacer placement. If revision knee arthroplasty is impossible, the «gold standard» for this kind of patients is knee joint arthrodesis. The purpose of the study was the comparative analysis of knee joint fusion by external and internal fixation. Materials and Methods. The analysis of 60 cases of knee arthrodesis was carried out. The patients were divided into two groups with 30 patients in each. In the first group, knee arthrodesis was performed with long locking nail, in the second group — with external ring fixation. We compared the groups by intraoperative and drainage blood loss, the inpatient treatment duration, the terms of fusion and complications registered. The patients quality of life was evaluated using the SF-36 questionnaire before surgery, for the periods of 3, 6, and 12 months after the surgery. Results. The comparison of two methods of knee arthrodesis showed that blood loss in the internal fixation compared with external one, was 2.03 times more, the duration of inpatient treatment was 1.4 times less, and the total number of complications was 4.4 times less. However, the complications that affected the treatment outcome in long nail group were 1.5 times more. The differences in the average time of ankylosis formation were not statistically significant (p<0.05). The functional results of the treatment in 3 months after surgery in the group with internal fixation were much better. In 6 months after surgery the quality of life had no significant differences. In 12 months follow-up the indices in both groups were the same. Conclusion. The results of our study suggests us to think, knee joint arthrodesis by long fusion nail should be prefereble. If the nail insertion is technically impossible, and there is the high risk of deep infection recurrence, the external osteosynthesis should be used.

Local antibiotic therapy for endoprosthesis site infection (Literature review)

2021 ◽  
Vol 90 (4) ◽  
pp. 78-85
Author(s):  
T.A. Kilmetov ◽  
◽  
I.F. Akhtyamov ◽  
Keyword(s):  
Comparative Analysis ◽  
Literature Review ◽  
Antibiotic Therapy ◽  
Musculoskeletal System ◽  
Treatment Options ◽  
Revision Arthroplasty ◽  
Infectious Complications ◽  
Site Infection ◽  
Local Antibiotic ◽  
Local Antibiotic Therapy

Endoprosthetics of joints has firmly taken its place in a number of orthopedic interventions in the treatment of diseases of the musculoskeletal system. Unfortu-nately, with an increase in the number of operations, the number of complications that develop at various stages of treatment does not decrease. Deep infections in the area of the endoprosthesis (paraprosthetic infection) are especially difficult in treatment, since only 20% of patients, and mainly in early forms of complications, manage to save the implant. The incidence of infectious complications at the stationary stage in specialized endoprosthetics centers does not exceed 1% during primary operations, but their number, as a rule, multiplies several years after the intervention. The most common treatment option for paraprosthetic infection is staged revision arthroplasty. The authors of the review conduct a comparative analysis of the effectiveness of one- and two-stage treatment options. The latter is based on the use of bone cement spacers impregnated with antibiotics.

scholarly journals Physiological Gait versus Gait in VR on Multidirectional Treadmill—Comparative Analysis

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 517 ◽  
Author(s):  
Katarzyna Jochymczyk-Woźniak ◽  
Katarzyna Nowakowska ◽  
Jacek Polechoński ◽  
Sandra Sładczyk ◽  
Robert Michnik
Keyword(s):  
Comparative Analysis ◽  
Knee Joint ◽  
Hip Joint ◽  
Pelvic Tilt ◽  
Plantar Flexion ◽  
Center Of Mass ◽  
The Body ◽  
Joint Rotation ◽  
Active Motion ◽  
Flexion Extension

Background and objectives: Virtual reality (VR) is increasingly often finding applications in physiotherapy and health promotion. Recent years have seen the use of advanced technologies in the promotion of physical activity (PA) in society. New simulators, e.g., treadmills, enable the performance of PA (e.g., locomotive movements) in VR (artificially created virtual world). The question of how such movements are similar to natural forms of human locomotion (march, run) inspired the comparative analysis of physiological gait and gait in VR on a multidirectional Omni treadmill. Materials and Methods: The tests involved the use of the BTS Smart system for the triplanar analysis of motion. The test involved 10 healthy females aged 20–24 (weight: 52 ± 3.1 kg, height 162 ± 5.4 cm). Measurements were performed at two stages. The first stage involved the standard assessment of physiological gait, whereas the second was focused on gait forced by the Omni treadmill. The following gait parameters were analyzed: Flexion-extension in the ankle, knee joint and hip joint, rotation in the hip joint and knee joint, foot progression, adduction-abduction in the knee joint and hip joint, pelvic obliquity, pelvic tilt, pelvic rotation as well as energy expenditure and the movement of the body center of mass. Results: The analysis of the test results revealed the existence of differences in the kinematics of physical gait and gait on the treadmill. The greatest differences were recorded in relation to the dorsal-plantar flexion in the ankle, the foot progression, the rotation of the knee joint, pelvic tilt and rotation. In addition, the gait on the treadmill is characterized by the longer duration of the stance phase and reduced ranges of the following movements: Flexion-extension in the ankle, knee joint and hip joint, adduction-abduction in the hip joint as well as rotation in the ankle and hip joint. The values of potential, kinetic and total energy recorded in relation to forced gait are significantly lower than those of physiological gait. Conclusions: Because of the fact that the parameters of gait on the Omni platform vary significantly from the parameters of physical gait, the application of the Omni treadmill in the re-education of gait during rehabilitation should be treated with considerable care. Nonetheless, the treadmill has adequate potential to become a safe simulator enabling active motion in VR using locomotive movements.

scholarly journals Short- vs. Long-Course Antibiotic Treatment for Acute Streptococcal Pharyngitis: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 733
Author(s):  
Anna Engell Holm ◽  
Carl Llor ◽  
Lars Bjerrum ◽  
Gloria Cordoba
Keyword(s):  
Antibiotic Therapy ◽  
Randomized Controlled Trials ◽  
Antibiotic Treatment ◽  
Clinical Cure ◽  
Randomized Clinical Trials ◽  
Streptococcal Pharyngitis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Short Course ◽  
Long Course

BACKGROUND: To evaluate the effectiveness of short courses of antibiotic therapy for patients with acute streptococcal pharyngitis. METHODS: Randomized controlled trials comparing short-course antibiotic therapy (≤5 days) with long-course antibiotic therapy (≥7 days) for patients with streptococcal pharyngitis were included. Two primary outcomes: early clinical cure and early bacterial eradication. RESULTS: Fifty randomized clinical trials were included. Overall, short-course antibiotic treatment was as effective as long-course antibiotic treatment for early clinical cure (odds ratio (OR) 0.85; 95% confidence interval (CI) 0.79 to 1.15). Subgroup analysis showed that short-course penicillin was less effective for early clinical cure (OR 0.43; 95% CI, 0.23 to 0.82) and bacteriological eradication (OR 0.34; 95% CI, 0.19 to 0.61) in comparison to long-course penicillin. Short-course macrolides were equally effective, compared to long-course penicillin. Finally, short-course cephalosporin was more effective for early clinical cure (OR 1.48; 95% CI, 1.11 to 1.96) and early microbiological cure (OR 1.60; 95% CI, 1.13 to 2.27) in comparison to long-course penicillin. In total, 1211 (17.7%) participants assigned to short-course antibiotic therapy, and 893 (12.3%) cases assigned to long-course, developed adverse events (OR 1.35; 95% CI, 1.08 to 1.68). CONCLUSIONS: Macrolides and cephalosporins belong to the list of “Highest Priority Critically Important Antimicrobials”; hence, long-course penicillin V should remain as the first line antibiotic for the management of patients with streptococcal pharyngitis as far as the benefits of using these two types of antibiotics do not outweigh the harms of their unnecessary use.

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