Background: Treatment of large bone defects and fracture healing complications (delayed and nonunion) presents a substantial challenge for orthopaedic surgeons. Given that bone healing requires mechanical stability as well as a favourable biological microenvironment, orthobiologics such as Platelet-Rich Plasma (PRP) may have a significant clinical role to play. Aims: To perform a systematic review of the available literature to assess the clinical effect of PRP, with or without other orthobiologics, on bone healing. Method: Two independent reviewers performed the literature search based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Clinical studies of any evidence, assessing effect of PRP with or without other orthobiologics on bone healing, were included. A qualitative analysis was carried out on the clinical and radiological outcomes reported. Result: 27 articles with 1631 patients (mean age ¼ 43.56, 57.1% male, mean follow-up ¼ 17.27 months) were included in the qualitative. Of the 27 studies, 13 dealt with fracture complications (delayed or nonunions), 7 with acute fracture healing, 4 with tibial osteotomies and lengthening procedures and 3 with lumbar spine pathology. 18/27 studies showed a clinical benefit of PRP, 8/27 showed no significant effect, and 1/27 showed a worse outcome with PRP. Conclusion: Our review suggests PRP may play a clinical role in bone healing but further randomised controlled trials (RCTs) using standardised outcomes should be performed to establish its efficacy.
Purpose: Pediatric urethral surgery represents a significant surgical challenge due to smaller pelvis, decreased caliber and increased tissue fragility. This study aims to find the outcome and complications of perineal end to end anastomotic urethroplasty in the management of posterior urethral injury resulting from pelvic fracture. Methods: We performed 47 perineal bulbo-prostatic anastomotic urethroplasty for PFUIs from January, 2013 to January 2020. Mean age was 13 years with majority between 10 to 18 years (>85%). All were male patients. Two patients had history of failed anastomotic urethroplasty. Patients were selected as per selection criteria and were prepared for operation after adequate counseling. After surgical intervention patients were discharged with a supra-pubic catheter (SPC) and per urethral catheter in situ. On 22nd POD urethral catheter was removed and SPC on the next day if patient can void normally. 1st and 2nd follow up done on of 3rd and 6th month respectively following surgery. If patient voided well and Qmax>15ml/ sec; repair was defined as successful. Results: Success rate of anastomotic urethroplasty for PFUI was 91.47%. Total 4 procedures were failed including 1 urethro-cutaneous fistula and needed re-do anastomosis. We could not evaluate erectile dysfunction (ED) as many patients were unable to give appropriate information. Two patient developed incontinence which improved in subsequent follow-up. Conclusions: Anastomotic urethroplasty remains the gold standard in the management of PFUI. Operative series of pediatric urethral reconstruction usually involve small numbers. Experiences of anastomotic urethoplasty in large volume adult series reflects the higher outcome in pediatic patients. Bangladesh J. Urol. 2021; 24(1): 77-81
Purpose: This study aims at finding the outcome and complications of perineal end toend posterior anastomotic urethroplasty in the management of posterior urethral injuryresulting from pelvic fracture. Methods: We performed 49 perinealbulbo-prostatic anastomotic urethroplasty for PFUIsfrom January, 2013 to April, 2017. Mean age was 37 years with majority between 21 to50 years (>85%). All were male patients. Three patients had history of failed anastomoticurethroplasty. Patients were selected as per selection criteria; detailed history and preoperativeinvestigations were done and were prepared for operation after adequatecounseling. After surgical intervention patients were discharged with a supra-pubiccatheter (SPC) and per urethral catheter in situ. On 22nd POD urethral catheter wasremoved and SPC on the next day if patient can void normally. 1st and 2nd follow updone on of 3rd and 6th month respectively following surgery. If patient voided well andQmax>15ml/ sec; repair was defined as successful. Results: Success rate of perinealbulbo-prostatic anastomotic urethroplasty for pelvicfracture urethral injury was 89.79%. Total 5 procedures were failed including 1 urethrocutaneousfistula and needed re-do anastomosis. Erectile dysfunction (ED) was presentin 6 patients before operation and after surgery 4 more patients developed ED and totalnumber was 10 during first follow up, which reduced to 8 during second follow-up. Onepatient developed incontinence which improved in subsequent follow-up. Conclusions: Anastomotic urethroplasty remains the cornerstone in the managementof PFUI. A long term follow-up for at least 5 to 10 years is needed to make a comment onultimate outcome of this procedure which may have positive impact in future patientmanagement. Bangladesh Journal of Urology, Vol. 22, No. 1, January 2019 p.75-79
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.