A complementary analytical tool for hip prosthesis dislocation: Thermal imaging in rehabilitation.

The use of routine ionizing imaging in identify and classify patients with dislocation or infection after surgery has some medical contraindication, in addition to risks associated with the ionizing load and elevated costs. A novel, less expensive and non-ionizing imaging technique, called infrared thermal imaging, can be proposed as a complementary method to routinely evaluate hip prosthesis patients and track their inflammation response following serious complications. Here we report a case of a total hip prosthesis which was dislocated during inpatient rehabilitation, and ultimately reduced without surgical procedure. During the process, routine clinical and radiographic diagnosis was complemented with an infrared examination. The infrared images were easy to take bedside, without direct contact with the area of surgery, and well tolerated. After the dislocation reduction, the thermal imaging procedure provided important feedbacks on the local inflammation, helping to exclude other complications such as the infections.

Effectiveness of two rehabilitation treatments in the modulation of inflammation during the acute phase in patients with knee prostheses and assessment of the role of the diet in determining post-surgical inflammation.

CLINICAL TRIAL NUMBER: NCT04580069. BACKGROUND: Total knee arthroplasty is associated with an elevated inflammatory response both at a local and systemic level. The main objective of this study is to demonstrate the effectiveness of lymphatic drainage and connective tissue techniques in modulating systemic inflammation. Another objective is to evaluate the existence, at baseline, of a correlation between the inflammation indices and the level of adherence to the Mediterranean diet. METHODS: 34 patients were recruited, and divided into three groups. The control group followed the normal rehabilitation protocol. The other two groups were subjected, in addition to the standard treatment, to manual lymphatic drainage treatment or connective tissue techniques. The outcomes were recorded in three stages: upon entering the hospital, 1 week after entry and at follow-up 21 days after surgery. RESULTS: The results of the study showed that both methods, compared with the standard treatment only, positively influenced the final outcomes. In regard to the systemic inflammation, lymphatic drainage and connective techniques showed equal efficacy and similar timing in modulating ESR, while they differ in how they affect CRP. With regard to the local inflammation, the effectiveness of both methods was confirmed with some differences in the location. Finally, analysis of the correlation between inflammatory T0 indices and adherence to the Mediterranean diet showed that patients with higher adhesion index have on average lower PCR, EDO and EDU values. CONCLUSIONS: The post-surgical inflammatory pattern can be positively modified by the rehabilitation methods analyzed, albeit with different methodologies and timing.The influence of the diet on inflammatory parameters, although less evident, seems to show encouraging results worth of further studies.