To describe the outcomes of 7 cases of psoas abscess concurrent with septic arthritis of the hip treated by hip arthroscopy alone.We retrospectively collected the data of patients who underwent arthroscopic drainage of psoas abscess concurrent with septic arthritis of the hip. Arthroscopic debridement was performed in both the central and peripheral hip joint compartments. In all cases, the iliopsoas compartment was accessed from the peripheral compartment through an anterior capsulotomy without limb traction. After debridement and drainage of the iliopsoas compartment, a suction drain tube was placed in the iliopsoas compartment through an enlarged anterior capsulotomy and another tube in the peripheral compartment. Postoperative intravenous antibiotics were administered on the basis of culture results; in cases with no positive culture, empirical antibiotics were administered for 4 to 6 weeks after surgery.7 patients underwent arthroscopic debridement and drainage for a psoas abscess concurrent with hip joint septic arthritis. Laboratory tests were normalized within 4 weeks after hip arthroscopy in all patients. At a median follow-up of 16 months (range, 13-30 months) after surgery, infection recurrence was absent in all patients.Arthroscopic debridement alone could be an effective treatment alternative to open surgery for psoas abscess concurrent with hip joint septic arthritis.
Titanium–Nickel shape memory alloy (TiNi SMA) has great potential as a biomaterial in orthopaedic applications due to its unique thermal shape memory effects, superelasticity and high damping properties. We designed and manufactured bone fixaters using newly developed TiNi SMA wire (Af, 35±2°C). Two bone fixater designs (single and double ring) were prepared for the treatment of bone fracture in twenty patients (6 distal femur, 5 distal fibular, 4 distal tibia, 2 metacarpal bone, 2 periprosthetic fracture and 1 subtrochanter of femur). Serial radiographs, complete blood count (CBC) and urine analysis were performed postoperatively. Radiological union was achieved without complications in approximate eight weeks after operation. There were no abnormal findings on follow-up CBC or urine analysis. On a subjective level, use and application of the TiNi SMA fixater was not as demanding as conventional fixation methods, such as cerclage or the Dall-Miles technique. The efficacy of SMA bone fixater in this study is very excellent as demonstrated in this clinical study. It gives the new armament to orthopedic surgeon.
Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear.We also attempted to determine the variants that affect the functional & structural outcomes.Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation.The average age at the time of the operation was fifty six years.The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder.Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff.We measured the intraoperative tear size in the sagittal and coronal planes.Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles.Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane.Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography.The average clinical outcome scores all significantly improved at the time of follow-up.At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon.Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction.However, the problems about how to enhance healing of the repaired tendon still remain.
Guidance assistance systems are expected to have a fundamental role in the near future ITS scenario. This paper describes the fundamental differences between the automated system and guidance system design. Solutions to these problems adopted in the parking assistance system development is described. The solution includes the proposal of human guidance system based on path generation and human interface. The proposed scheme implementation, the performed experiments and obtained experimental results are also reported.
Purpose: To analyze the results of total knee arthroplasty (TKA) in patients with diabetes mellitus (DM). Materials and Methods: Between 1996 and 2001, 601 TKAs in 373 patients were performed by a single surgeon. From this series, 45 patients (74 knees) were diagnosed as type II DM and osteoarthritis of the knee. The mean follow-up was 49 months (6-108 months), and the mean age was 68.6 years (54-83 years). The clinical outcome of the diabetic and non diabetic group was compared using the Hospital for special surgery score (HSS) and the Knee society clinical and radiological scoring system. The radiological loosening and perioperative complications were evaluated. The plasma Hemoglobin A1c (HbA1c) level of the diabetes patients was examined pre and postoperatively. Results: The knee and pain scores were higher in the diabetes group postoperatively (p=0.040, p=0.039, respectively), whereas the HSS scores and overall function scores were lower in the diabetes group postoperatively (p=0.021, p=0.016, respectively). The rate of superficial wound problems was greater in the diabetes group (8.1% versus 2.4%, p=0.032). However the incidence of a deep infection was similar in the diabetic and non diabetic group (2.7% versus 0.9%). The mean HbA1c level was significantly higher in the diabetic patients with a superficial and deep infection than in the remaining diabetic patients (p=0.033). Conclusion: The HbA1c level might be a valuable predictor of superficial wound complications and deep infection. Although the clinical results were similar in the diabetes and non diabetes groups, special precautions should be taken for diabetic patients undergoing TKA to minimize complications.
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