Knee
Mohammad H. Kaseb; Seyed Mohammad J. Mortazavi; Mohammad Ayati Firoozabadi; Hesam Toofan
Volume 7, Issue 5 , September 2019, , Pages 441-444
Abstract
Background: Patellar crepitus after total knee arthroplasty (TKA) is not uncommon. The choice between patellarresurfacing or retention in TKA has remained controversial. Therefore, this randomized controlled trial aimed to evaluatethe impact of patellar resurfacing on the incidence of patellar crepitus. ...
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Background: Patellar crepitus after total knee arthroplasty (TKA) is not uncommon. The choice between patellarresurfacing or retention in TKA has remained controversial. Therefore, this randomized controlled trial aimed to evaluatethe impact of patellar resurfacing on the incidence of patellar crepitus. In addition, we compared the clinical outcomesand satisfaction between the patients who underwent patellar retention or resurfacing.Methods: A total of 63 patients randomly received patellar resurfacing or non-resurfacing TKA by one surgeon at ImamKhomeini Hospital Complex, Tehran University of Medical Sciences, Iran during May 2014-February 2017. Finally,29 patients in the resurfaced group and 44 subjects with retained patella were evaluated pre-op and in an averagefollow-up period of 8.68 months using the clinical Knee Society Score (KSS), functional KSS, and Knee injury andOsteoarthritis Outcome Score (KOOS).Results: Our findings demonstrated no significant difference between the two groups regarding the satisfactionof patients, KSS, and KOOS. It was shown that the latter scores improved in both groups in the follow-up period.Nonetheless, patellar crepitus was not statistically different between the two groups.Conclusion: According to the results of the present study, patellar resurfacing did not lead to decreased patellarcrepitus or enhanced clinical outcomes of TKA.Level of evidence: I
General Orthopedics
John King; Pim Van Dijk; Celeste Overbeek; Michiel Hageman; David Ring
Volume 5, Issue 2 , March 2017, , Pages 74-81
Abstract
Background:Patient concerns represent opportunities for improvement in orthopaedic care. Thisstudy’s objectiveis to identify the nature and prevalence of unsolicited patient complaints regarding orthopaedic care ata tertiary referral hospital. The primary null hypothesis that there are no demographic ...
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Background:Patient concerns represent opportunities for improvement in orthopaedic care. Thisstudy’s objectiveis to identify the nature and prevalence of unsolicited patient complaints regarding orthopaedic care ata tertiary referral hospital. The primary null hypothesis that there are no demographic factors associatedwith complaint types was tested. Secondarily we determined if the overall complaint number and typesdifferedby year.Methods:Complaints to the hospital ombudsperson by orthopaedic patients between January 1997 and June 2013 werereviewed. All 1118 complaints were categorized: access and availability, humaneness and disrespect, communication,expectations of care and treatment, distrust, billing and research.Results:Patients between 40 and 60 years of age filed the most complaints in all categories except distrust(more common in patients over age 80) and research. Women were slightly more likely to address access andavailability, humaneness, disrespect, and billing compared to men. The overall number of complaints peakedin 1999. The most common issue was access and availability followed by communication, and humaneness/disrespect.Conclusion:Half of concerns voiced by patients addressed interpersonal issues. The largest category was related toaccess and availability. Quality improvement efforts can address technology to improve access and availability as wellas empathy and communication strategies.
Ghasem Soltani; Mahmood Khorsand; ALireza Sepehri Shamloo; Lida Jarahi; Nahid Zirak
Volume 3, Issue 4 , October 2015, , Pages 280-285
Abstract
Background: Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient’s satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual ...
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Background: Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient’s satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual buprenorphine in postoperative pain control following closed reduction surgery. Methods: This triple blind clinical trial was conducted on 90 patients referred for closed reduction orthopedic surgery. They were older than 18 years and in classes I and II of the American Society of Anesthesiologists (ASA) with an operation time of 30-90 minutes. Patients were divided into two groups of buprenorphine (4.5μg/kg sublingually) and morphine (0.2mg/kg intravenously). Baseline characteristics, vital signs, pain score, level of sedation and pharmacological side effects were recorded in the recovery room (at 0 and 30 minutes), and in the ward (at 3, 6 and 12 hours). SPSS version 19 software was used for data analysis and the significance level was set at P Results: Ninety patients were studied, 60 males and 30 females with a mean age of 37.7±16.2 years. There was no significant difference between the two groups in terms of baseline characteristics.Pain score in the morphine group was significantly higher than the buprenorphine group with an average score of 2.5 (P<0.001). Postoperative mean heart rate in the buprenorphine group was four beats lower than the morphine group (P<0.001). Also, in the buprenorphine 48.6% and in the morphine group 86.7% of cases were conscious in recovery (P=0.001) with a higher rate of pruritus in the latter group (P=0.001). Conclusion: Sublingual buprenorphine administration before anesthesia induction in closed reduction surgery can lead to better postoperative pain control in comparison to intravenous morphine. Due to simple usage and longer postoperative sedation, sublingual buprenorphine is recommended as a suitable drug in closed reduction surgery.