OBJECTIVE: One of the most controversial issues in pediatric orthopedics is Developmental dysplasia of the hip (DDH). The timing of diagnosis and treatment are is the main goal to treat this condition successfully. Neglected cases that may remain undiagnosed until advancing age are still seen especially in developing countries. Delayed diagnosis and treatment with advancing age leads to more extensive surgery and cause low satisfactory rates. The aim of this study is to evaluate the effect of patients’ age on the results of single-stage treatment of Developmental Dysplasia of the Hip.MATERIAL AND METHODS: 23 patients (34 hips) treated in our hospital between 2004 and 2010 were included in the study. Single-stage treatment including open reduction, femoral shortening, and Salter’s innominate osteotomy was applied to patients whose mean age of surgery was 7.5 years. Radiological results were evaluated in terms of improvement in the acetabular index, in the acetabular angle and according to Severin’s classification, and Bucholz and Ogden’s avascular necrosis (AVN) classification at the final follow-up.RESULTS: The average follow-up period was 60 (range: 24 - 84) months. While the acetabular index was 39.7°±1.4° (range: 25°- 52°) preoperatively, it was measured as 21.8°±1.8° postoperatively. The mean amount of improvement in the acetabular angle was 17.9°±0.8°. According to Bucholz and Ogden’s classification, one patient (2.9%) had Type 1 AVN and one patient (2.9%) had Type 3 AVN. Radiologically, the success rate (85.7%) was significantly higher in children aged 8 years and younger (p = 0.008).CONCLUSIONS: According to the improvement in the acetabular index and Severin's radiological classification, successful results are obtained after a single-step treatment of DDH, which is treated in the 4-8 age range. However, the radiological results of children older than 8 years are worse than those under 8 years old.
Objective: To compare patients who received preoperative intravenous (IV) plus postoperative maintenance IV tranexamic acid (TXA) therapy and perioperative periarticular TXA to those who did not receive TXA during total knee arthroplasty (TKA) in terms of blood loss, transfusion requirements, and length of hospital stay.
Material and Method: Data from 194 patients who underwent TKA between 2016 and 2019 were reviewed. A total of 106 patients were included. Twenty-one patients were male, and 95 were female. The patients were divided into three groups: Group 1 (n=37) that did not receive perioperative TXA, Group 2 (n=35) that received preoperative IV and postoperative maintenance TXA therapy, and Group 3 (n=34) that received preoperative IV and perioperative periarticular TXA. The groups were similar regarding demographic data. Statistical comparisons between the groups were made concerning the decrease in hemoglobin levels on postoperative days 1 and 3, the need for transfusion, and the length of hospital stay.
Results: The mean decrease in hemoglobin on the postoperative first and third days were 1.69(±1.13) and 2.94(±1.14)g/dl, in Group 1, 1.41(±0.99) and 2.44(±1.28)g/dl, in Group 2, and 1.24(±0.83) and 2.21(±0.84)g/dl in Group 3 respectively. The statistical comparison of the hemoglobin decrease revealed a significant difference between Groups 1 and 3 on the postoperative first day(p
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