Patient specific instrumentation versus conventional knee arthroplasty: comparative study

Predescu, Vlad; Prescura, Catalin; Olaru, Razvan; Savin, L. H.; Botez, Paul; Deleanu, Bogdan

doi:10.1007/s00264-016-3356-3

Cited by 21 publications

(25 citation statements)

References 26 publications

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“…[17][18][19][20][21] A reduction in intra-or perioperative blood loss with PSI was observed in multiple reports, 18,[22][23][24][25][26] while other authors have failed to observe significant differences. 1,2,20,23,24,[27][28][29][30][31][32][33][34][35][36][37] However, only a handful of clinical studies exist, which were specifically designed to investigate perioperative blood loss after TKA with PSI, [1][2][3][38][39][40] and the sole meta-analysis examining blood loss indicates a minor and clinically not relevant difference in favor of PSI. 41 Our study offers a complete analysis of blood loss-related parameters and prospectively investigates with a regression model the treatment effect on Hb change.…”

Section: Discussionmentioning

confidence: 99%

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

et al. 2018

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Patient-specific instrumentation (PSI) may contribute to reduced blood loss related to total knee arthroplasty (TKA). The purpose of this study was to compare the estimated hemoglobin (Hb) and red blood cell volume (RBC) losses in two groups of patients undergoing TKA with PSI and conventional instrumentation. Pre- and postoperative blood samples were collected from 22 patients randomly assigned to receive a PSI-assisted or conventional TKA. Post- to preoperative Hb difference was calculated and RBC loss was estimated according to Sehat et al. A significant difference in Hb reduction in favor of the PSI group was registered on the last day of stay ( = 0.0084) and significant treatment effect ( = 0.027) on Hb reduction after intervention was found with a regression model for longitudinal measurements. This study demonstrated that PSI leads to a significant trend in earlier Hb regain. These promising results suggest a beneficial effect of PSI in blood loss reduction.

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Section: Discussionmentioning

confidence: 99%

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

et al. 2018

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“…In this disease, tumor masses are very vascularized, which means that embolization prior to extirpation can reduce intraoperative bleeding and facilitate the excision. In our case, there was no need to carry out a preoperative embolization, the surgical intervention was successful, without intraoperative incidents that might carr y hemorrhagic risk [11].…”

Section: Experimental Part Clinical Casementioning

confidence: 59%

The Role of the Immunohistochemical Examination in the Diagnosis of Castleman`s Disease

Bădulescu¹,

Hultoana²,

Ciuntu³

et al. 2017

Rev. Chim.

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Castleman�s disease is characterized by benign angiolymphoid hyperplasia. There are two clinical forms: the localized form in which one lymph node is affected, often paucisimptomatic, treated by radical surgical excision, without recurrence in most cases, and the multicentric form, characterized by systemic manifestations, polyadenopathy (mediastin, cervical region, abdomen, etc.) , organomegaly (e.g. spleen, liver), with a less favorable prognosis than the localized form. The etiology of the disease remains unknown; recent studies suggest the implication of human herpes virus 8 (HHV-8), especially in multicenter forms. We shall present the case of women, aged 23, with Castleman�s disease with retroperitoneal localization, who was admitted to the surgery clinic due to abdominal pains. The initial abdominal CT raised the suspicion of a hepatic lobus caudatus tumor, but the anatomical-pathological result confirmed the diagnosis of angiofolicular hyperplasia of the lymph nodes. Diagnostic methods, histological forms, treatment and prognosis aspects of Castleman�s disease are described below.

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“…The greatest therapeutic challenge remains in obtaining a balance with the antithrombotic treatment as to avoid deep vein thrombosis and severe postoperative bleeding or wound complications [ 9 ]. Computer assisted interventions are becoming an integrated part of medicine in the hopes of better outcomes and faster recovery times [ 10 ]. Lately, advanced imaging solutions such as the computer tomography and the magnetic resonance imaging, have allowed us to diagnose several types of affections and complications related to the skeletal system [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Deep vein thrombosis following the treatment of lower limb pathologic bone fractures – a comparative study

Mioc¹,

Prejbeanu

Vermeşan

et al. 2018

BMC Musculoskelet Disord

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BackgroundDeep vein thrombosis is a well-known complication of fracture occurrence, lower limb surgery and periods of prolonged immobilisation. Its incidence can be increased even more in specific cases with metastatic bone disease and adjuvant treatment. There is a small amount of literature that addresses the incidence of DVT by comparing osteosynthesis and arthroplasty as surgical treatments. Current recommended anticoagulation protocols might be inadequate for specific groups of cancer patients undergoing osteosynthesis or arthroplasty.MethodsThe study was designed and performed in a retrospective manner and carried out on patients that presented at our Emergency Clinical County Hospital between 01.01.2008–31.12.2016. The patients’ evolution was followed for a standard of 2 months. All our deep vein thrombosis events were diagnosed via venous duplex imaging. The studied lot (n = 85) was paired with a control group (n = 170) with similar baseline characteristics.ResultsOur lot was comprised of 85 patients that underwent 85 surgeries, on both of our hospital’s Orthopaedic and Traumatology wards. When performing the student t-test and calculating OR (odds ratio) and RR (risk ratio) we encountered 11 cases of DVT in our studied group and 12 cases of DVT in our control group (p < 0.04). We found statistical significance when correlating DVT with type of implant (prosthesis), the presence of metastases over primary tumour and the choice of implant (prosthesis over intramedullary nail). There was no statistical significance found when correlating DVT events with the type of anticoagulation and the amount of blood transfusion units required.ConclusionPatients who undergo surgical treatment for lower limb pathological fracture due to malignancy are at increased risk of DVT or death due to PE under current general thromboprophylaxis regimens. The risk is higher for the immediate postoperative period (10 days). The risk is increased by metastasis, arthroplasty and adjuvant therapy (radiotherapy, chemotherapy), and we think that a more aggressive prophylactic protocol should be used.

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Patient specific instrumentation versus conventional knee arthroplasty: comparative study

Abstract: We cannot recommend PSI-TKR for a better outcome. It is an alternative to conventional and computer-assisted TKR, but further studies are needed to evaluate weather surgical or economic benefits may be achieved by choosing customised instruments.

Cited by 21 publications

References 26 publications

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

The Role of the Immunohistochemical Examination in the Diagnosis of Castleman`s Disease

Deep vein thrombosis following the treatment of lower limb pathologic bone fractures – a comparative study

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