Online ISSN: 2515-8260

Keywords : arthroplasty


A Physiological Prophylaxis of Deep Venous Thrombosis in Arthroplasty: A Prospective Study

Syed Mohd Noaman Quadri, G. Niranjan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 146-152

Background: A potentially lethal condition is known as venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis (DVT). To determine the effectiveness of pharmacological prophylaxis against PE or DVT (Pulmonary Embolism). To ascertain the prevalence of DVT (Deep Venous Thrombosis) or PE (Pulmonary Embolism) despite prevention. On the subject, relatively few studies from India have been published, and nothing is known about the true prevalence of the disorder. Due to a sharp rise in the number of joint replacement surgeries, the topic has recently taken on more importance among Indian people. Regarding the prophylaxis for VTE in Indian patients, there are no precise recommendations.
Materials and Methods: In order to investigate the prevalence of DVT, we designed and carried out a prospective study. The current study comprised a total of fifty patients who had undergone THR, TKR, or HRA. The duplex ultra-sonography was performed on each of the patients between the seventh day and the third week of postoperative day. As a preventative measure against deep vein thrombosis (DVT), all patients received subcutaneous Enoxaparin 40 mg once day for 5 days and Asprin for 4 weeks.
Results: Only two patients or four percent of the total, revealed sonographic evidence of distal asymptomatic DVT, and both of those patients' symptoms went away on their own without any treatment. During the follow-up scan, there was no evidence of proximal DVT propagation, and there were also no incidences of pulmonary embolism.
Conclusion: DVT in patients who have undergone THR, TKR, or HRA is not nearly as common as it is reported to be in the Western medical literature. It is essential to maintain a high level of suspicion, in addition to close clinical surveillance. In our society, deep vein thrombosis (DVT) is hardly an unheard-of condition. Although low molecular weight heparin is a safe medicine, it appears that the risk of bleeding problems is higher than what is described in Western medical literature. In the future, it will be necessary to conduct additional trials that involve a greater number of patients and take place at many centres in order to corroborate the findings of our study and evaluate the actual efficacy and safety of LMWH.

A STUDY OF THE FUNCTIONAL RESULT OF CEMENTED TOTAL HIP ARTHROPLASTY USING MOORE'S PROCEDURE

Anvesh Gattu, Biju Ravindran, Otturu. Sukanya

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2897-2907

Background: One of the most common causes of human locomotion impairment is hip joint pain. Total hip arthroplasty is the most significant single advancement in modern orthopedic surgery. By replacing damaged cartilage surfaces with various artificial bearing materials, surgeons have been able to improve function and relieve pain in the vast majority of patients. The current study was carried out to investigate the functional outcome and complications associated with cemented total hip replacement using a modular prosthesis. Moore's approach, which is commonly used in our institution, is used in all of the cases.
Materials and Methods: In this study, 30 patients with 30 diseased hips were treated with cemented total hip replacement using modular prosthesis by Moore's approach in our institution between September 2020 and September 2021, and were followed up for 1-24 months.
Results: Patients were evaluated functionally as well as radiologically. Functional evaluation using the Modified Harris hip score revealed excellent results in 17 patients (60%), 7 patients ( 30%) were the good results, and 3 patients (10%) had in fair condition. There were no negative outcomes. The most recent radiological evaluation of all cases revealed no signs of aseptic dislocation or implant failure.
Conclusion: We achieved results comparable to other authors by using proper patient selection, adequate planning, armamentarium, and meticulous surgical technique. In a nutshell, this procedure performed with the utmost technical precision at our institute yielded very good clinical results. If done with extreme care and precision, functional results are excellent and complications are minimal. Long-term studies are required to investigate late complications and to demonstrate the efficacy of the implants and procedure.

Outcome of total knee replacement in osteoarthritis

Dr. Venugopal Palakurthi, Dr. Srimukthi Madhusudan, Dr. B Srinivas, Dr. V Krishna Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3147-3155

Background and Objectives: To investigate and assess the functional results of complete knee replacement surgery. To determine whether or not there has been an improvement in post-operative pain relief. The knee joint's degree of stability as well as its range of motion to investigate the risks and potential problems of total knee replacement surgery. The pre-operative Knee Clinical Score will be compared to the post-operative Knee Clinical Score. The pre-operative Knee Functional Score will be compared to the post-operative Knee Functional Score. In order to evaluate the radiological results of the total knee replacement procedure. Research will be conducted to investigate the connection between the Knee Clinical Score and the Knee Functional Score.
Methods: A total of 20 patients who had total knee replacements were included in this prospective analysis. Cases were selected based on certain criteria, both for inclusion and disqualification. At each patient's scheduled follow-up appointment, the Knee Society Score was applied to assess their condition. Within the participants of our study, there were a total of 20 female patients and 10 male patients. Indications were 15 cases of OA and 1 case of RA. The duration of the follow-up period was typically twenty weeks.
Results: In the course of our research, prior to surgery, every one of our patients experienced moderate to severe pain; but, following surgery, 16 of the patients only experienced mild discomfort. Following surgery, the patient's average flexion, which was 75 degrees preoperatively, increased to 94 degrees. Before surgery, each of the 15 knees received a knee score of less than 60, but after surgery, some of the knees received an exceptional score (80 to 100), while the other knees received a good score (72-79). Prior to surgery, 10 patients had a functional score that was below 60, and two patients had a functional score that was between 60 and 69. Postoperatively, 20 patients had a score that was considered to be outstanding (85-100), 10 patients had a score that was considered to be good (72-79), 6 patients had a score that was considered to be acceptable (61-69), and 2 patients had a score that was considered to be poor (60).
Conclusion: The surgical method known as total knee arthroplasty is now widely practiced and well-established. The functional outcome of the surgery is impressive, long-lasting, and gratifying, and patient acceptability is very high.