Early Complications Following Bipolar Hemiarthroplasty for Femoral Neck Fracture in Elderly Patients

Background: The femoral neck fracture is one the most important traumatic event in the elderly, because of its high rate and terrible complications. The most frequently used surgical option for the management of displaced intracapsular femoral neck fractures is the bipolar hemiarthroplasty. This study examines the incidence of early complications following bipolar hemiarthroplasty procedures for the management of femoral neck fractures using posterior approach.Methods: We retrospectively reviewed 1 year follow up of 150 patients with displaced femoral neck fracture who underwent hemiarthroplasty at our institution between 2007 and 2012. Several variables including age, sex, medical comorbidities, type of fracture, operation time, intraoperative complications, hospitalization time, surgical site infection, systemic infection, prosthesis dislocation periprosthetic fracture, pulmonary thromboembolism, mortality and Harris Hip score were examined.Results: There were 82 males and 68 females in this study. Mean age of patients was 71.4 years. There were no intraoperative mortality, however, one year follow up mortality rate was 7.33%. There were 6.66% early dislocation and surgical site infection was seen in 2.66% of patients. Venous thromboembolic events occurred in 2.66% of patients. The average HHS improved significantly at one year follow up.Conclusions: Our study showed that bipolar hemiarthroplasty through posterior approach is associated with a modest rate of complications

Intra-Articular Injections for Pain Relief Following Knee Arthroscopy: A Literature Review

Arthroscopy procedures for the knee are excellent and tend to be outpatient procedures. Pain control after arthroscopic surgery is an important aspect of patient satisfaction and quicker return to daily activities following surgery. The objective of this article was to review the current literature regarding pain management after knee arthroscopy using intra-articular (IA) injections. Our goal in this article is to review the drugs that have been suggested in various articles for IA injections following knee arthroscopy to control pain. In conclusion, the current evidence suggests that combining IA lidocaine and morphine with tranexamic acid (TXA), in addition to ketorolac, is effective for pain relief after arthroscopic knee surgery

Total Knee Arthroplasty: Does the Tibial Medial Side Defect Affect Outcome?

Primary knee osteoarthritis (OA) is one of the degenerative diseases that destroy auricular cartilage within knee joint and cause pain, varies deformity, decrease knee function. Total knee arthroplasty (TKA) is an effective intervention in order to relieve pain, improve function and QOL (quality of life) in patients with severe osteoarthritis of the knees that have different degrees of varus deformity. However, we are not aware of any study to shows if medial side defect in tibia has any association with outcome. We conceive this study of finding out if medial side defect of tibia affects the outcome. 124 patients (143 knees) with primary knee OA with different stages of defects participated in this study. Patients classified into two groups based on Rand classification of knee defects (patients with Rand I and II in group 1 and patients with Rand III and IV in group 2). Pain and knee alignment have been measured by Visual analog scale (VAS) and 3-joint X-ray and quality of life, knee function and radiographic have been measured by questionnaires of SF 36, WOMAC and KSS score. The mean follow-up was 18. 2 mounts (range 12 to 23 months). The results showed that all of the parameters improved significantly within groups (P≤0.001). Comparison TKA between two groups in the postoperative analysis shows that there was a significant difference between groups in pain, radiographic and functional KSS and WOMAC score (P≤0.05). So group 1 had better results in these parameters than group 2 after surgery. TKA is an effective intervention for all patients with severe osteoarthritis and varus deformity. However, the severity of medial tibial defects is an important determinant of outcome. Patients with a more severe deformity have less favorable outcome