Local infiltration analgesia with bupivacaine and adrenaline does not reduce perioperative blood loss in total hip arthroplasty.

This study evaluates the effect of local infiltration analgesia with bupivacaine and adrenaline on perioperative blood loss in total hip arthroplasty. Patients who had primary total hip arthroplasty were retrospectively assigned to two groups. One group had 100 ml of bupivacaine/adrenaline solution injected into periarticular soft tissues at the end of the procedure. There were 55 patients in the infiltrated hip group and 44 patients in the not infiltrated group. Patients' hemoglobin level (Hb), hematocrit (HTC), red blood count (RBC), platelet count (PLT) and International Normalized Ratio (INR) as well as the need for blood transfusions were compared statistically between groups preoperatively and postoperatively. There were no significant differences between Hb, HTC or RBC levels as well as the rate and amount of blood transfusions on the 1st, 4th postoperative days or at patients' discharge between infiltrated and not infiltrated groups. This study does not support the hypothesis that the use of local infiltration analgesia with adrenaline may reduce perioperative blood loss in total hip arthroplasty.

The Thermal Sensitivity Test in Evaluating Outcome after Peripheral Nerve Injury.

The purpose of this study was to evaluate the ability to discriminate temperatures in patients following peripheral nerve injury. Knowing that temperature sensibility is mediated by different receptors, the scores were compared to other functional hand scores in order to determine whether the ability to discriminate temperatures is restored to a different extent compared with other commonly evaluated hand function modalities. The test was performed using the NTE-2 device (Physitemp Instruments Inc., 154 Huron Avenue, Clifton, New Jersey, USA). Out of 57 patients, 27 had normal thermal discrimination scores, and 9 could not tell the temperatures apart in the differences set on the measuring device. Overall, patients with better thermal discrimination had also better hand function as evaluated with different methods. However, some patients who did regain the ability to differentiate temperatures correctly did not have any measurable return of hand function in other tests. Thermal discrimination scores correlated similarly with different functional scores, except for vibration sensibility, which did not show any significant correlation. The development and severity of cold intolerance seem to be unrelated to temperature sense.

Outcome in corrective osteotomy for malunited distal radius fractures.

BACKGROUND: This article reports outcome in osteotomy for malunion of distal radius fractures. MATERIAL AND METHODS: We evaluated 12 patients with distal radius malunion (mean age 54), who were treated with corrective osteotomy. Wrist motion and grip strength were evaluated, along with examination of pre and post osteotomy radiographs. The indications for corrections were degree of deformity, limitation of function, pain, and the appearance of the wrist. RESULTS: The radiographic evaluation proved that the restoration of the normal anatomic relationship between the distal radius and ulna leads to significant improvement of the function of the hand, as measured by range of motion and grip strength. CONCLUSION: Osteotomy of the distal radius in cases of malunion gives favorable outcomes.

Outcome in the arthroscopic treatment of synovial chondromatosis of the knee.

Background. Synovial osteochondromatosis is a disease in which loose cartilaginous bodies develop around large joints, usually the knee. It is caused by synovial metaplasia of unknown etiology. Symptoms are due either to mechanical problems caused by the loose bodies or to the degenerative arthritis that follows after several years. Surgical or arthroscopic removal of the loose bodies appears to be the only effective treatment. This article reports treatment outcome in synovial chondromatosis of the knee. Material and methods. We treated 13 patients: 11 by arthroscopy and 2 by arthrotomy. The follow-up examination was performed at least two years after after surgery. Results. There were 6 good and very good outcomes, while 2 patients required arthroscopic re-operation. Conclusions. Arthroscopy seems to be the treatment of choice in synovial chondromatosis of the knee.