Postoperative acute acalculous cholecystitis (AAC) was a well-known abdominal complication of general surgery [1-3], but in orthopedic surgery only sporadic case reports could be retrieved [4-7]. Postoperative AAC was unrelated to the biliary tract, which was characterized by gallbladder inflammation without evidence of calculi or sludge [8]. Once postoperative AAC occurs, the disease progressed fastly, such as obscure, fulminating, and rapid progression to sepsis and perforation, which may eventually lead to death. As far as we know, there has been no report published about AAC following cemented hemiarthroplasty in hip fracture patients. Herein, we report an extremely rare case of postoperative AAC following cemented hemiarthroplasty in a hip fracture patient where proper diagnosis was made and an otherwise potentially fatal outcome was averted.
Objective To compare the analgesic effects and adverse reactions of dezocine and sufentanil for patient-controlled intravenous analgesia(PCIA) in hysterectomy.Methods Sixty patients without critical organ dysfunction,aged from 36～70 ys,ASAⅠ～Ⅱgrade,were randomized into two groups(n=30).Each patient was given PCIA followed by operation.The PCIA regimen was dezocine 40 mg combined with ondansetron 8.0 mg in N.S 100 ml for Group A and sufentanil 100 μg combined with ondansetron 8.0 mg in N.S 100 ml for Group B.The visual analogue scales(VAS) was adopted to assess pain intensity and side effects and the assessments were recorded at 6,12,24,48 h after operation.Results There was no significant difference in analgesic effect and adverse reactions between the Group A and B.Conclusion The analgesic effect of dezocine-based PCIA is available and reliable for postoperative pain management followed by hysterectomy.
Objective To compare the clinical efficacy and safety of arthroscopic internal drainage for the treatment of unicameral popliteal cysts with or without cyst wall resection. Methods This was a retrospective case–control study of 73 patients diagnosed with unicameral popliteal cysts from January 2012 to January 2019 who received arthroscopic treatment. The study included 38 cases with cyst wall resection (CWR group) and 35 cases with cyst wall preservation (CWP group). The CWR group consisted of 14 men and 24 women with an average age of 51.8 years, while the CWP group consisted of 13 men and 22 women with an average age of 52.0 years. All patients were examined for intra‐articular lesions and communicating ports by magnetic resonance imaging (MRI) prior to surgery, and recurrence of cysts was evaluated at the last follow‐up examination. Rauschning and Lindgren grade (R–L grade) and Lysholm score were used to evaluate clinical outcomes. In addition, operation time and complications were recorded. Results The average length of follow‐up was 24.2 months (range, 16 to 32 months). There were no considerable differences in age, gender, cyst size, Lysholm score, R–L grade and concomitant intra‐articular cases between the CWR group and CWP group prior to surgery ( P > 0.05). The last follow‐up MRI scans showed that in the CWR group, the cyst disappeared in 25 cases and shrunk in 13 cases. In the CWP group, the cyst disappeared in 22 cases, shrunk in 12 cases and persisted in one case. There was no obvious difference in recurrence rate between the two groups (0% vs 2.9%, P = 0.899). At the last follow‐up, there were no differences in the R–L grade ( P = 0.630) and Lysholm score (88.3 ± 5.6 points vs 90.1 ± 3.8 points, P = 0.071) between the two groups. Compared with the CWP group, operation time was significantly prolonged in the CWR group (38.3 ± 3.1 min vs 58.3 ± 4.4 min, P < 0.05). In the CWR group, three cases occurred fluid infiltration under the gastrocnemius muscle, which improved after pressure bandaging and cold compress. In another three cases, hematoma was found. The incidence of complications in the CWR group was markedly higher than that in the CWP group (15.8% vs 0%, P < 0.05). During the follow‐up period, none of the patients developed serious complications such as neurovascular injury, deep venous thrombosis, or infection. Conclusion For unicameral popliteal cysts, arthroscopic internal drainage combined with resection of the cyst wall did not further improve the clinical outcomes or reduce the recurrence rate, while prolonging the operation time and increasing the possibility of complications.
Objective To evaluate the clinical effect of the one‐stage repair of a posterior oblique ligament avulsion fracture combined with a medial collateral ligament injury. Methods This study was a retrospective trial. From February 2007 to May 2017, five patients with posterior oblique ligament avulsion fracture combined with medial collateral ligament injury were included in this study. The patients were aged 37–58 years old with a mean of 45.2 years. All patients underwent the primary repair of a posterior oblique ligament avulsion fracture and medial collateral ligament injury. The main observational index included Lysholm score, International Knee Documentation Committee (IKDC) score, Visual Analogue Scale (VAS) score, and range of motion (ROM). Results The results showed that the average time of follow‐up was 53.6 months (range, 20–86 months). When compared to preoperative scores, the preoperative Lysholm score was significantly increased (47.8 ± 5.1 vs 95.0 ± 3.7, P < 0.05), the IKDC score was significantly increased (51.2 ± 5.6 vs 88.6 ± 4.2, P < 0.05), the VAS score was significantly decreased (7.0 ± 0.7 vs 0.4 ± 0.5, P < 0.05), and the ROM was significantly increased (91.6° ± 8.4° vs 129.9° ± 4.4°, P < 0.05). Conclusion Our study found that with the combination of the one‐stage repair of a posterior oblique ligament (POL) avulsion fracture and medial collateral ligament injury, the patient's postoperative function recovered well, their pain was relieved, and their knee joint stability was reliable.
Abstract Background: Many traditional methods are available to prevent unbalance of extension and flexion gap during total knee arthroplasty (TKA), but there are no reports on the use of measurement and positioning method before tibial osteotomy with self-made tools.We designed a self-made tool measuring the location before tibial osteotomy and determined the clinical effect. Methods: The retrospective study included patients who received TKA at our hospital, between January 1, 2012 and December 31, 2015. A new method, named as the measurement and localization before osteotomy with self-made tools, was developed to measure the osteotomy position of the posterior femoral condyle during TKA. They were divided into two groups, one that received the new method (GroupⅠ), and the other that received the traditional method as a control (GroupⅡ). HSS score, Oxford score, VAS score and knee joint activity were evaluated in two groups. Results: One hundred and eighty-seven of 210 eligible patients were included. The function of knee joint in all patients was improved and the pain was obviously relieved. Significant differences were found in the HSS score, Oxford score, VAS score, knee joint activity between two groups at 5-year follow-up ( p <0.05). Conclusions: The biomet knee prosthesis was selected for all intraoperative implants. All operations were completed by the same senior surgeon.The use of self-made tools may contribute to improve the balance between flexion and extension gaps as well as the balance between internal and external gaps during TKA, and overcome knee flexion instability.
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