Post-Operative Pain After Knee Arthroscopy and Related Factors

The aim of this study was to explore the intensity of post-arthroscopy knee pain during the first 24 hours, and to study the influence of pre-operative pain, tourniquet time and amount of surgical trauma on post-arthroscopy pain. In 78 male patients that underwent elective arthroscopic menisectomy or diagnostic arthroscopy of the knee, preoperative and post-operative pain were registered using the Visual Analogue Scale. Variance for repeated measures and for independent observations was analysed. Supplementary analgesia was required for 23% of the patients, more often in the recovery room and between 2 and 8 hours postoperatively. Of all factors analyzed, only time was statistically significant in determining the level of post-operative pain. Supplementary analgesia was required only in patients that underwent operative arthroscopy, and more often in patients with tourniquet time of more than 40 minutes. In conclusions, post-operative time is the most significant factor related to the post-arthroscopy knee pain

Validation and cross-cultural adaptation of Greek version of Achilles tendon Total Rupture Score

Background: The purpose of this study was the translation, cross-cultural adaptation and validation of the Achilles Tendon Total Rupture Score (ATRS) in Greek population. Methods: The translation and cross-cultural adaptation of the original version of ATRS in Greek language was performed according to the methodology described by Beaton et al. Validation and test–retest reliability were evaluated in forty-six patients, treated surgically for acute Achilles tendon rupture. Validity was evaluated by correlation of total and all subscale scores of Greek version of Manchester Foot Pain and Disability Index (MFPDI). Test–retest reliability evaluated with interclass correlation coefficient and Crombach's α coefficient was used for internal consistency. Results: The internal consistency (α = 0.96) and test–retest reliability (ICC = 0.97) were excellent. There were no ceiling and floor effects during test–retest assessment. The Greek version of ATRS showed strong correlation with all subscales and overall score of MFPDI (pain subscale: R = −0.954, p < 0.01, function subscale: R = −0.811, p < 0.01, appearance subscale: R = −0.763, p < 0.01, overall: R = −0.914, p < 0.01). Conclusions: Greek version of ATRS was successfully adapted in Greek population and it appears to be a valid and reliable instrument to evaluate outcomes in Greek speaking patients after Achilles tendon rupture. Level of evidence: Level III. © 2017 European Foot and Ankle Societ

Cross-cultural adaptation and validation of the International Knee Documentation Committee Subjective Knee Form in Greek

Background: Patient-reported outcomes require validation in a particular language and culture before administration for clinical use. Materials and methods: A systematic translation of the IKDC Subjective Knee Form was initially tested in 30 patients with various knee pathologies to develop the first Greek version (IKDC/SKF-GR). It was then administered to another 80 patients. The test–retest reliability (n = 35) and internal consistency (n = 80) were examined. Construct validity was tested by correlating the IKDC/SKF-GR with the SF-36 subscales (n = 80) and content validity by measuring floor/ceiling effects. Responsiveness was measured in patients with meniscus pathology (n = 24). Results: Patients filled the form without omissions/questions regarding the phrasing of items. Internal consistency was good (Cronbach’s α = 0.87) and test–retest reliability very good (ICC2,1 = 0.95, SEM = 4.4 and SDC = 12.2). Correlations with the SF-36 subscales confirmed its construct validity. No floor/ceiling effects were recorded. The effect size was large (ES = 1.26). Conclusions: The IKDC/SKF-GR has comparable measurement properties to the original form. Level of evidence: Level II. © 2015, The Author(s)

Simultaneous dislocation of the radial head and distal radio-ulnar joint. A case report

<p>Isolated dislocation of the distal radio-ulnar joint and isolated dislocation of the radial head in adults are not common injuries. A simultaneous dislocation of the radial head and distal radio-ulnar joint with no other injury seems to be extremely rare since only one report was found in the English literature. A similar case, but with some differences in presentation and treatment is reported.</p

Risk assessment instruments for screening bone mineral density in a Mediterranean population

AIM To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country. METHODS Data concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal women aged 42-87 years who underwent dual-energy X-ray absorptiometry (DEXA) screening. Six osteoporosis risk factor screening tools were applied to this sample to evaluate their performance and choose the most appropriate tool for the study population. RESULTS The most important screening tool for osteoporosis status was the Simple Calculated Osteoporosis Risk Estimation, which had an area under the curve (AUC) of 0.678, a sensitivity of 72%, and a specificity of 72%, with a cut-off point of 20.75. The most important screening tool for osteoporosis risk was the Osteoporosis Self-assessment Tool, which had an AUC of 0.643, a sensitivity of 77%, and a specificity of 46%, with a cut-off point of -2.9. CONCLUSION Some commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density. © 2016 Baishideng Publishing Group Inc. All rights reserved

Mechanical characterization of bone graft substitute ceramic cements

The aim of this laboratory work was to study the compressive and flexural characteristics of various commercially available bone graft substitute (BGS) ceramic cements, in their initial as-mixed condition, and compare them to polymethylmethacrylate (PMMA). The tested biomaterials were two different calcium phosphate cements, two different calcium sulphate cements, one nanocrystalline hydroxyapatite and one PMMA cement. All biomaterials were prepared according to manufacturers instructions and the methodology described in ISO 5833 (2002) for acrylic bone cement was followed, as the one closest approaching in vivo requirements. All BGS cements had a brittle behaviour and when subjected to mechanical stress they all failed under sudden crack propagations in their bulk. Both in compression and bending, all BGS cements failed under loads lower than those of PMMA. In compression, the calcium sulphate extra strength cement showed a strength value of approximately 60% of PMMA, the other cements following at a distance. In bending, all BGS cements showed strengths below 22% of PMMA. However, due to limited number and fragility of specimens, calculated bending strengths can only be considered as indicative figures with limited comparative value. The results of this in vitro study showed a varying mechanical performance between tested BGS ceramic cements, whilst all of them exhibited lower compression and bending strength than the selected PMMA. These findings, of course, cannot be directly extrapolated to surgical or clinical implications, since the adopted in vitro context does not necessarily reflect the actual in vivo conditions met by such biomaterials. © 2011 Elsevier Ltd. All rights reserved