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BACKGROUND: Although cardiac implantable electronic device (CIED) implantation is considered to be minor surgery, almost 60% of the patients suffer from shoulder-related problems a short time after the procedure. The purpose of this study was to determine the possible effects of the preference of the dominant side for CIED implantation on the ipsilateral superior extremity functions. METHODS: The study included a total of 107 patients who had been living with a CIED for >6 months. Patients were separated into two groups according to the dominant hand and side of the CIED. The ipsilateral dominant-hand group comprised those with a CIED on the same side as the dominant hand and the contralateral dominant-hand group included patients with the CIED placed on the contralateral side to the dominant hand. Visual analogue scale (VAS) pain score, quick disability of the arm shoulder and hand questionnaire (QuickDASH) and maximum isometric grip strength tests were used to evaluate the upper extremity disabilities. RESULTS: No significant difference was determined between the groups in respect of VAS pain scores (P = 0.10), QuickDASH scores (P = 0.21), and limitations of the shoulder joint range of motion (P = 0.192). The maximum isometric grip strength was significantly different in the right hands between two groups (34 [16-95]-40 [24-85]) (P = 0.02). CONCLUSION: The present study shows that the joint range of motion limitation, pain, and disability of the upper extremity were no different in the affected arm compared to the healthy contralateral side with respect to the placement of the CIED on the dominant or non-dominant side.
RESUMEN
OBJECTIVES: This study aims to assess whether platelet rich plasma (PRP) is an effective treatment for knee osteoarthritis, and compare its efficiency with corticosteroid treatment in terms of pain control, physical function, and quality of life. PATIENTS AND METHODS: The study included 50 patients (4 males, 46 females; mean age 61.6±6.9 years; range 50 to 75 years) who were diagnosed as grade 3 knee osteoarthritis. Patients were randomized into three groups as corticosteroid group (receiving one corticosteroid injection), single PRP group (receiving one PRP injection), and three PRP group (receiving three PRP injections with one week interval). All patients were given a home exercise program. Patients were evaluated with Visual Numeric Scale (VNS), Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC), Lequesne index and the Hospital Anxiety and Depression Scale before treatment, and at second and sixth months following the implementation of injections. RESULTS: In single and three PRP groups; VNS, WOMAC and Lequesne scores decreased significantly at second month follow-up; also, sixth month scores showed a slight increase but remained significantly lower than baseline. In corticosteroid group, all VNS, WOMAC, and Lequesne scores decreased at second month follow-up; however, at sixth month, rest, night VNS and WOMAC stiffness scores were increased while no significant difference was found with baseline. At sixth month; VNS movement, WOMAC pain, function, and the total and Lequesne scores were worse, but remained significantly lower than baseline. When groups were compared, three PRP group's second month VNS movement scores were significantly lower than the corticosteroid group. Sixth month VNS movement and WOMAC pain scores were significantly lower in single and three PRP groups compared to the corticosteroid group, with no significant difference between the PRP groups. CONCLUSION: Our findings revealed that PRP is a safe treatment option and efficient in osteoarthritis symptom control up to six months after application. Treatment response obtained with corticosteroid injection has a shorter duration than PRP treatment.
