The effect of perioperative blood transfusion on kidney functions in total knee Arthroplasty.

OBJECTIVE: Various studies have examined the effects of perioperative blood transfusion on kidney functions. In this study, we investigated the effects of blood transfusion on the kidney functions of patients undergoing total knee arthroplasty. METHODS: : This retrospective study was carried out on 216 patients who had undergone total knee arthroplasty between January 2016 and January 2017. The patients were divided into two groups according to the level of blood transfusion used during surgery. Group-1 comprised 157 patients (72.7%) needing a blood transfusion of less than three units, while the 59 (27.3) patients in Group-2 required three or more than three units. RESULTS: No statistical difference was found between the two groups regarding hypertension before surgery, diabetes mellitus, chronic kidney failure, smoking habits or lung disease (p> 0.05). Likewise, there was no significant difference related to pulmonary and other complications or mortality (p> 0.05). When the groups were compared according to their blood parameters, no statistical differences in postoperative renal or other system functions were found (p> 0.05). CONCLUSIONS: Blood transfusion does not have a negative effect on postoperative blood urea nitrogen (BUN) and creatinine levels, or glomerular filtration rate in total knee arthroplasty.

The effect of inclination angle on the strength of vertical mattress configuration for meniscus repair.

PURPOSE: Vertical mattress configuration is the strongest of all other configurations and the repairing devices of meniscus repair. The purpose was whether increasing the inclination angle between two strands of the vertical mattress configuration by increasing the amount of meniscus tissue captured would enhance the initial strength of the construction. METHODS: A 2-cm long anteroposterior vertical longitudinal incision was created in two groups of bovine medial menisci. In the first group, the distance between the two vertical suture strands and the vertical horizontal sutures on the capsular side of the meniscal lesion was 2 mm (Group 1). In the second group, the distance was 5 mm (Group 2). The following repair specimens underwent cyclic loading prior to loading the failure testing. The endpoints included ultimate failure load (N), stiffness (N/mm) and cyclic displacement (mm) after the 100 cycles and the mode of failure. RESULTS: Group 1 (2 mm) (90.7 (±19.9) N) had lower ultimate load than Group 2 (5 mm) (120.8 (±24.5)) (P < 0.05). Stiffness and displacements during the cycling were not different between the groups (n.s.). All specimens failed by suture rupture. CONCLUSION: Increased inclination angle with increased distance between the two vertical suture strands on the capsular side of the meniscal lesion resulted in higher failure load compared to control group with lower inclination angle and distance on the capsular side.

EFFECT OF PLATELET-RICH PLASMA, FAT PAD AND DURAL MATRIX IN PREVENTING EPIDURAL FIBROSIS.

OBJECTIVE: Epidural fibrosis is one of the main reasons for requiring repeated surgical intervention. Our objective was to compare the effect of Platelet Rich Plasma (PRP) on the development of epidural fibrosis with collagen dural matrix and free autogenous fat graft. METHODS: Male rats were separated into 3 groups. Laminectomy was implemented on the rats and epidural fat pad was placed in the first group (n = 7); equal size of collagen dural matrix was applied in the second group (n = 7); a single dose of PRP was applied in the third group (n = 7). RESULTS: Epidural fibrosis was more common in the group that collagen dural matrix was applied when compared the ones that PRP was applied. PRP group presented better values in preventing epidural fibrosis when compared to the fat pad group, however this difference was not statistically significant. CONCLUSION: PRP is a material that can be easily obtained from the very blood of patients and at an extremely low cost; the main clinical relevance of our study is that the PRP might be an efficient material for better clinical results after laminectomy surgery due to its tissue healing and epidural fibroris preventing potentials. Level of Evidence V, Animal research.

OBJETIVO: A fibrose epidural é uma das principais razões que motiva intervenções cirúrgicas repetidas. O objetivo deste estudo foi comparar o efeito do plasma rico em plaquetas (PRP) no desenvolvimento de fibrose epidural com matriz de colágeno e enxerto de gordura autógena. MÉTODOS: Ratos machos foram separados em 3 grupos. A laminectomia foi aplicada nos ratos e gordura epidural foi colocada no primeiro grupo (n = 7); matriz de colágeno de tamanho igual foi aplicada no segundo grupo (n = 7); uma dose única de PRP foi aplicada no terceiro grupo (n = 7). RESULTADOS: A fibrose epidural foi mais comum no grupo em que a matriz de colágeno foi aplicada, quando comparada aos animais do grupo PRP. O grupo PRP apresentou os melhores valores na prevenção da fibrose epidural quando comparado ao grupo enxerto de gordura, porém a diferença não foi estatisticamente significante. CONCLUSÃO: PRP é um material de fácil obtenção do sangue dos pacientes e a baixo custo; a principal relevância clínica de nosso estudo é que o PRP pode ser um material eficiente para obter melhores resultados clínicos após a laminectomia devido à sua cicatrização tecidual e potencial de prevenção de fibrose epidural. Nível de evidência V, Pesquisa com animais.

The Effect of Autologous Platelet Rich Plasma in the Treatment of Achilles Tendon Ruptures: An Experimental Study on Rabbits.

BACKGROUND: Achilles tendon ruptures are characterized by a long recovery period, high re-rupture rate and late return to work. To overcome these difficulties and augment tendon repair, many agents have been used. AIMS: To determine the effect of autologous platelet rich plasma (PRP) in the treatment of Achilles tendon ruptures in rabbits. STUDY DESIGN: Animal experimentation. METHODS: The study included 14 New Zealand albino rabbits that were divided randomly into 2 groups, A and B, each containing seven rabbits. On day zero, all 28 Achilles tendons were tenotomized and repaired. In group A, the tendons were injected with PRP post-surgery, whereas those in group B were left untreated. On day 28, the right tendons in both groups were examined histopathologically via both light and electron microscopy, and the left tendons were subjected to biomechanical testing. RESULTS: The histological and biomechanical findings in both light and electron microscopy in group A were better than those in group B, but the difference was not significant. According to Tang's scale, the mean value in Group A was 3.57, while it was 3.0 in Group B. The mean value of Group A for the length of collagen bands was 48.09 nm while the mean value of Group B was 46.58 nm (p=0.406). In biomechanical tests, although stiffness values were higher in group A, the difference between groups was not significant. In addition, maximum load values did not differ between groups A and B. CONCLUSION: PRP had no effect on the healing process 28 days post-Achilles tendon rupture.

Effect of platelet-rich plasma, fat pad and dural matrix in preventing epidural fibrosis / Efeito do plasma rico em plaquetas, enxerto de gordura e matriz de colágeno na prevenção da fibrose epidural

ABSTRACT Objective: Epidural fibrosis is one of the main reasons for requiring repeated surgical intervention. Our objective was to compare the effect of Platelet Rich Plasma (PRP) on the development of epidural fibrosis with collagen dural matrix and free autogenous fat graft. Methods: Male rats were separated into 3 groups. Laminectomy was implemented on the rats and epidural fat pad was placed in the first group (n = 7); equal size of collagen dural matrix was applied in the second group (n = 7); a single dose of PRP was applied in the third group (n = 7). Results: Epidural fibrosis was more common in the group that collagen dural matrix was applied when compared the ones that PRP was applied. PRP group presented better values in preventing epidural fibrosis when compared to the fat pad group, however this difference was not statistically significant. Conclusion: PRP is a material that can be easily obtained from the very blood of patients and at an extremely low cost; the main clinical relevance of our study is that the PRP might be an efficient material for better clinical results after laminectomy surgery due to its tissue healing and epidural fibroris preventing potentials. Level of Evidence V, Animal research.

RESUMO Objetivo: A fibrose epidural é uma das principais razões que motiva intervenções cirúrgicas repetidas. O objetivo deste estudo foi comparar o efeito do plasma rico em plaquetas (PRP) no desenvolvimento de fibrose epidural com matriz de colágeno e enxerto de gordura autógena. Métodos: Ratos machos foram separados em 3 grupos. A laminectomia foi aplicada nos ratos e gordura epidural foi colocada no primeiro grupo (n = 7); matriz de colágeno de tamanho igual foi aplicada no segundo grupo (n = 7); uma dose única de PRP foi aplicada no terceiro grupo (n = 7). Resultados: A fibrose epidural foi mais comum no grupo em que a matriz de colágeno foi aplicada, quando comparada aos animais do grupo PRP. O grupo PRP apresentou os melhores valores na prevenção da fibrose epidural quando comparado ao grupo enxerto de gordura, porém a diferença não foi estatisticamente significante. Conclusão: PRP é um material de fácil obtenção do sangue dos pacientes e a baixo custo; a principal relevância clínica de nosso estudo é que o PRP pode ser um material eficiente para obter melhores resultados clínicos após a laminectomia devido à sua cicatrização tecidual e potencial de prevenção de fibrose epidural. Nível de evidência V, Pesquisa com animais.