Bipolar Hemiarthroplasty (HA) procedure allows patients after a neck femur fracture to be able to perform early mobilization. Hence complications due to prolonged bed rest could be prevented. Early mobilization should be achieved immediately after bipolar HA surgery. There are several factors affecting early mobilization in patients, some of which include tissue damage during surgery (creatine kinase), inflammatory status of patients (IL-6) and implant position (femoral offset). This study aims to show whether lower levels of creatine kinase, IL-6 and femoral offset can result in better Harris Hip Score following Bipolar HA surgery day 14 and day 30. By knowing the influencing factors, it is hoped that more accurate management could be carried out. Thus, the outcome parameters of early mobilization in the form of returning to daily life and work activities are getting better and the risk of complications can be avoided. This study compared the Harris Hip Score (HHS) in patients who'd already had Bipolar Hemiarthroplasty using a prospective cohort study design (Bipolar HA) who met the inclusion criteria at the Central General Hospital (RSUP) Prof I.G.N.G Ngoerah Denpasar and provided them informed consent. In order to do descriptive analysis, normality and homogeneity tests, and proportion comparison analysis, the research data was entered into a research sheet and processed using a computer and the SPSS for Windows version 26 program. In this study, the sample data (n=32) was not normally distributed. Lower levels of IL-6 (< 15 pg/ml), and FO values (< 42.5 mm) resulted in better HHS values in patients following Bipolar HA surgery day-14. Additionally, lower levels of CK (< 75 U/L), IL-6 (< 15 pg/ml), and FO values (< 42.5 mm) resulted in better HHS values in patients following bipolar HA surgery on day-30. Chi-Square analysis showed that the results of CK levels day-14 were statistically insignificant (p= 0.072>0.05), while the results of CK levels day-30 were statistically significant (p=0.033<0.05). Moreover, chi-Square analysis showed that the results of day-14 and day-30 were statistically significant on IL-6 levels (p-0.016<0.05 and p= 0.015<0.05), and FO values (p= 0.012<0.05 and p-0.033<0.05). It is concluded that lower levels of IL-6, and FO values resulted in better HHS values in patients following Bipolar HA surgery day-14. Additionally, lower levels of CK, IL-6, and FO values resulted in better HHS values in patients following bipolar HA surgery on day-30.
Introduction: Arthrofibrosis is a debilitating complication of loss of motion after ACL reconstruction following ACL injury with a reported incidence of 2% to 35%. Delayed ACL reconstruction has been the chosen management based on the suggestion from some studies of the risk reduction in developing arthrofibrosis and decreased range of motion (ROM) postoperatively. Case Presentation: A 51-year-old female presented with complaints of pain, stiffness, and decreased range of motion following a knee ligament reconstructive arthroscopy of her right knee. After unsuccessful rehabilitative management, the patient underwent additional surgical repairs. Following the surgery, a fibrous thick scar tissue located at the suprapatellar pouch and mainly over the medial and lateral gutter was observed, in which an adhesiolysis was performed during the arthroscopic procedure. Passive range of motion of the affected knee was checked intra-operatively, showing the knee to be able to fully extend and flexed passively comparable to non affected knee. An intensive physiotherapy and continuous passive motion was begun immediately post-operatively. A 33-year-old male sustained an isolated complete tear of the left knee anterior cruciate ligament. An arthroscopy ACL single bundle reconstruction surgery with patellar tendon bone graft was done four weeks after the injury. Intraoperative was uneventful. Each end of graft was stitched together with a high strength of non-absorbable suture. Graft fixations used bio absorbable screws and loaded with extracortical buttons. After post operation, patient was observed to be able to perform full active knee extension. The patient was very compliant to rehabilitation program and also performed the exercises at home. However, on clinic follow-up, the patient started to gradually loss his active full extension and on subsequent visit further affected his passive full extension (10 degrees extension lag) at 4 months post operation. Regional examination showed diffused firm swelling over the anteromedial aspect of the knee just above the medial joint line that was very tender. An intensive physiotherapy and continuous passive motion were begun immediately post operatively. Result: In the first patient, the functional outcome score showed improvement at the time of final follow-up, as well as the average pain scores. This case report emphasized on the importance of early recognition as well as assessment by the orthopaedic practitioners of arthrofibrosis as a complication of ACL reconstructive surgery is the key point in reducing the long-term morbidity caused by the condition in patients unable to regain flexibility at the expected rate after injury or surgical treatment. Rehabilitation protocols should mainly stress on early motion, rapid return of quadriceps function and excursion, and patella mobilization. The second patient, functional outcome was measured with KSS to assess pain and function after arthroscopy. The functional outcome score showed improvement from 68 points pre-operatively to 86 at the time of final follow-up. The average pain scores improved as well from 30 points pre-operatively to 41 at the time of final follow-up. Conclusion: Arthrofibrosis following ACL reconstruction represents a broad continuum of abnormalities, and hence a thorough understanding of the condition and a comprehensive approach to its management is of importance to achieve a functional result. Key words: Arthrofibrosis, Loss of motion, ACL Reconstruction, Arthroscopy.
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.