Clinical efficacy of celecoxib for osteoarthritis and bone anchor assisted knee extensor reconstruction.

Celecoxib is the most recent non steroidal anti-inflammatory analgesic, and has been gradually used in the treatment of acute pain, rheumatism and osteoarthritis. This paper analyzes the analgesic effect of celecoxib in the treatment of knee osteoarthritis and put forward a new mechanism of knee joint extensor reconstruction assisted by bone anchor. The experimental group was given celecoxib 200 mg/ time and 1 time /d. The results showed that VAS (Visual Analogue Scale) decreased gradually in both groups on the 1st, 3rd and 7th day of treatment and VAS in experimental group was lower than that in control group at the same time point (P<0.05). At the 1 year follow-up, experience group had a significant improvement on the Lysholm (69.33 ± 8.38 preoperatively and 88.65 ± 12.93 postoperatively) and Kujula (69.33 ± 8.38 preoperatively and 88.65 ±12.93 postoperatively) knee scores (P<0.05). The results showed that celecoxib had a good analgesic effect in patients with knee osteoarthritis and reducing the release of inflammatory factors may be its mechanism..

Ultrasound-Guided Femoral Nerve Blockage in A Patellar Dislocation: An Effective Technique for Emergency Physicians.

BACKGROUND: Patellar dislocation is an orthopedic emergency and its reduction can be painful. The aim of this case is to show that the ultrasound-guided femoral nerve blockage can be effectively used in the pain management of patellar reduction in the emergency department (ED). CASE REPORT: A 21-year-old man was admitted to our ED after suffering a fall down a flight of stairs. The initial physical examination and plain radiography showed a patellar dislocation in the right knee. We performed an ultrasound-guided femoral nerve blockage to provide a pain-free and comfortable patellar reduction. To our best knowledge, there is no manuscript except an old case series about use of the ultrasound-guided femoral nerve blockage in the management of patellar reduction in the medical literature. Procedural sedation is the preferred method used for this purpose in ED, but these medications need to be closely monitored because of their potential complications, such as nausea, vomiting, allergic reactions, and respiratory depression. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Ultrasound-guided femoral nerve blockage gave rapid and effective pain control without any complication during the reduction in this patient. Therefore, we suggest this technique be used for pain management during the reduction of a dislocated patella in the ED.

Plicatura artroscópica del retináculo medial combinada con liberación del retináculo lateral en el tratamiento de la luxación rotuliana traumática / Arthroscopic medial retinaculum plication combined with lateral retinaculum release in the treatment of traumatic patellar dislocation

Objetivo: El objetivo fue analizar el efecto curativo de la plicatura artroscópica del retináculo medial (PARM) combinada con la liberación del retináculo lateral (LRL) para el tratamiento de la luxación rotuliana traumática. Métodos: Se recogieron retrospectivamente los datos de los pacientes con luxación rotuliana traumática desde enero de 2015 hasta diciembre de 2020. El grupo de control fueron los pacientes que recibieron reconstrucción del ligamento patelomeniscal medial (LPMM); el grupo de observación fueron los con PARM en forma de abanico combinada con LRL. La longitud de la incisión, la función de la rodilla, los parámetros del examen de TC y el costo hospitalario se compararon entre los dos grupos antes y después de la cirugía. Resultados: El grupo de control y el grupo de observación incluyeron 35 y 39 pacientes, con una edad pro-medio de 18,8±5,3 años y 18,1±5,9 años, respectivamente. Los parámetros de TC preoperatorios y la puntuación de Lysholm y la puntuación de Kujala de los dos grupos no fueron estadísticamente significativos. Ambos grupos lograron buenos resultados posoperatorios. No hubo diferencias significativas en los parámetros de TC posoperatorios y la puntuación de Kujala, pero el grupo de observación fue más dominante en la longitud de la incisión, la prueba de movilidad rotuliana, la puntuación de Lysholm y el costo hospitalario (p < 0,05). Conclusión: La PARM combinada con LRL en el trata-miento de la luxación rotuliana traumática tiene las ventajas de menos trauma, baja tasa de recurrencia, bajo costo y eficacia confiable a corto plazo. (AU)

Objetive: The aim of this study was to analyze the cu-rative effect of arthroscopic medial retinaculum plication (MRP) combined with lateral retinacu-lum release (LRR) for the treatment of traumatic patellar dislocation. Methods: The data of patients with traumatic patellar dislocation treated from January 2015 to December 2020 were retrospectively collected. The con-trol group was the patients who received medial patellomeniscal ligament (MPFL) reconstruction; the observation group was the patients with ar-throscopic fan-shaped MRP combined with LRR. The incision length, knee function, CT examina-tion parameters, and hospital cost were compared between the two groups before and after surgery. Results: The control group and the observation group included 35 and 39 patients, with an average age of 18.8±5.3 years and 18.1±5.9 years, respec-tively. The preoperative CT parameters, and Ly-sholm score and Kujala score of the two groups of patients were not statistically significant. Both groups of patients achieved good results after sur-gery. There was no significant difference in post-operative CT parameters and Kujala score, but the observation group was more dominant in inci-sion length, patellar mobility test, Lysholm score, and hospital cost (p < 0.05). Conclusion: Arthroscopic MRP combined with LRR in the treatment of traumatic patellar dislocation has the advantages of less trauma, low recurrence rate, low cost, and reliable short-term efficacy. (AU)

Low dose erythropoietin stimulates bone healing in mice.

Beyond its classical role in regulation of erythropoiesis, erythropoietin (EPO) has been shown to exert protective and regenerative actions in a variety of non-hematopoietic tissues. However, little is known about potential actions in bone regeneration. To analyze fracture healing in mice, a femoral 0.25 mm osteotomy gap was stabilized with a pin-clip technique. Animals were treated with 500 U EPO/kg bw per day or with vehicle only. After 2 and 5 weeks, fracture healing was analyzed biomechanically, radiologically and histologically. Expression of PCNA and NFκB was examined by Western blot analysis. Vascularization was analyzed by immunohistochemical staining of PECAM-1. Circulating endothelial progenitor cells were measured by flow-cytometry. Herein, we demonstrate that EPO-treatment significantly accelerates bone healing in mice. This is indicated by a significantly greater biomechanical stiffness and a higher radiological density of the periosteal callus at 2 and 5 weeks after fracture and stabilization. Histological analysis demonstrated significantly more bone and less cartilage and fibrous tissue in the periosteal callus. Endosteal vascularization was significantly increased in EPO-treated animals when compared to controls. The number of circulating endothelial progenitor cells was significantly greater in EPO-treated animals. The herein shown acceleration of healing by EPO may represent a promising novel treatment strategy for fractures with delayed healing and non-union formation.