[Purpose] To assess the effects of different numbers of platelet-rich plasma (PRP)
applications on pain and physical function in grade 3 knee osteoarthritis (OA). [Subjects
and Methods] A total of 102 patients with grade 3 knee OA were randomly divided into three
groups: Group 1 received a single injection of PRP, Group 2 received two injections of PRP
two weeks apart, Group 3 received three injections of PRP at 2-weeks intervals. All
patients were evaluated with a visual analog scale (VAS), the Western Ontario and McMaster
Universities Arthritis Index (WOMAC), and the Timed-Up and Go test (TUG) before the
treatment and at 1, 3 and 6 months after the treatment. [Results] Ninety-eight patients
(15 males, 83 females) completed the study. The mean ages of the patients were 53.5±6.6,
54.9±5.3, and 55.1±5.6 years in Group 1, Group 2, and Group 3, respectively. Statistically
significant improvements were noted in all of the evaluated measures in all of the groups.
The mean differences of Group 1-Group 2 and Group 1-Group 3 WOMAC total, WOMAC pain, WOMAC
stiffness, and WOMAC function scores were statistically significant. [Conclusion] PRP is
an effective treatment for functional status and pain in moderate knee osteoarthritis and
a minimum of two injections is appropriate.
[Purpose] The aim of this study was to investigate the effect of the addition of NMES to
the post-TKA rehabilitation protocol on the functional status and quality of life of the
patients. [Subjects and Methods] Patients were randomized into an exercise (control) and
electrical stimulation (NMES) group. A home exercise program was prescribed for the
control group. For the neuromuscular stimulation group 30 minute electrical stimulation
applied to the vastus medialis muscle 5 days a week for 4 to 6 weeks. VAS, the timed up
and go test, WOMAC and SF-36 scores were evaluated preoperatively and postoperatively at
the first month and the third month of the follow-up period. [Results] Both the NMES group
had 30 patients each, with 2 and 1 male patients respectively. The comparisons of WOMAC
results at month 1 revealed that pain, stiffness, and total scores of the NMES group was
significantly better than those of control group at the first and third months.
Significantly better physical function and SF-36 subscales, except mental health, were
found for the NMES group at the first month of follow-up. [Conclusion] The inclusion of
the neuromuscular electrical stimulation program after knee arthroplasty was more
effective at providing rapid improvements in knee pain, walking distance and quality of
life.
Background
It is still unknown whether bioabsorbable magnesium (Mg) screws provide an advantage over titanium screws in the treatment of medial malleolar (MM) fractures. The purpose of this retrospective study is to compare the clinical and radiological outcomes of MM fractures fixed with either bioabsorbable Mg screws or conventional titanium screws.
Materials and methods
A cohort of 48 patients with MM fractures who underwent compression screw fixation was retrospectively reviewed. Twenty-three patients (16 male, 7 female; mean age: 37.9 ± 17.7 years) were treated with bioabsorbable Mg screws, and 25 patients (14 male, 11 female; mean age: 45.0 ± 15.7 years) were treated with conventional titanium screw fixation. All patients were followed up for at least 1 year, with a mean time of 24.6 ± 10.5 months (12–53 months). The American Orthopedic Foot and Ankle Society (AOFAS) scale was used to evaluate the clinical results. The Kellgren–Lawrence (KL) osteoarthritis grading was used to evaluate posttraumatic osteoarthritis on final ankle radiographs. Fracture union, rate of implant removal, and complications were recorded. Comparative analysis of two independent groups was performed using the chi-squared test and the Mann–Whitney U-test.
Results
The two groups were comparable concerning demographic and clinical characteristics. Age (p = 0.146), sex (p = 0.252), side (p = 0.190), MM fracture type (p = 0.500), associated fractures (p = 0.470), and follow-up period (p = 0.903) were similar between the groups. At final follow-up examination, AOFAS score (p = 0.191) was similar between groups. Fracture union was achieved in all cases. Grade of posttraumatic osteoarthritis, according to KL, was equally distributed in both groups (p = 0.074). No deep infection or osteomyelitis was seen. Five patients in the titanium screw group underwent implant removal, due to pain in three of them and difficulty in wearing shoes in the other two (p = 0.031). Implant removal was performed after a mean of 14.2 ± 3.1 months (12–19 months).
Conclusions
Bioabsorbable Mg and titanium screws had similar therapeutic efficacy in MM fracture fixation regarding functional and radiological outcomes. However, the rate of implant removal was higher with titanium screws. Bioabsorbable Mg screws may be a favorable fixation option since secondary implant removal procedures can be prevented.
Level of evidence
Level IV, Retrospective case series.
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