Osteoarthritis Research[Comparative study on effects of combined massage-smouldering-washing therapy and mini-invasive surgery in treating knee osteoarthritis]Primary Author: Zhi-Xue OuPrimary Author: Department of Orthopedics, Guilin Hospital of TCM, Guilin. ouzhixue99@sina.comDate Published: 2009 01 06Abstract: OBJECTIVE : To comparatively study the curative effects of combined massage-smouldering-washing therapy (MSW) and mini-invasive surgery in treating knee osteoarthritis (KOA) of mild-moderate degree so as to provide a suitable therapeutic protocol. METHODS: Sixty patients with KOA were assigned to two groups. The treatment group was treated with MSW once a day for 10 days as one course, and 4 courses were applied totally with an interval of 3 days between courses. The control group was treated with mini-invasive surgery by arthroscopic mopping, followed with post-operational intra-articular cavity injection with sodium hyaluronate injection, 20 mg every week for 5 times continuously. The therapeutic effect and the changes in scores of clinical symptoms and signs before and after treatment in the two groups were observed and compared. RESULTS: Outcome of 3-month follow-up showed the effective rate was 90% in the treatment group and 93.33% in the control group; scores of clinical symptoms and signs effectively improved in both groups, but the improvement on the 4 items (joint pain, swelling, soreness of loin and knee, and cold aversion of knee) was superior in the treatment group, while that on the other 4 items (pain during squatting or half-squatting, up stairs or down stairs, joint stiffiness and joint kinetic capacity) was superior in the control group (P < 0.05). CONCLUSION: Both MSW and mini-invasive surgery have definite curative effect on KOA but with different particularities.
Long-term results of cemented metal-backed glenoid components for osteoarthritis of the shoulder.Primary Author: Nattapol TammachotePrimary Author: Mayo Clinic, 200 First Street S.W., Rochester, MN 55902, USA.Date Published: 2009 01 05Abstract: BACKGROUND: There has been recent renewed interest in the use of metal-backed glenoid components in total shoulder arthroplasty. However, little information is available on the long-term results. The purpose of this study was to determine the results, the risk factors for an unsatisfactory outcome, and the failure rates of total shoulder arthroplasty with a cemented metal-backed glenoid component. METHODS: Between 1985 and 1991, 100 total shoulder arthroplasties with Neer cemented metal-backed glenoid components were performed at our institution to treat osteoarthritis. Ninety-five shoulders were followed for a minimum of two years (mean, 10.8 years) or until the time of revision surgery. Patients were assessed with use of a modified Neer rating system at the time of the latest follow-up. Radiographs of eighty-three shoulders were assessed for the presence of glenoid erosion, glenohumeral subluxation, periprosthetic lucency, and a shift in component position. RESULTS: Total shoulder arthroplasty with a cemented metal-backed glenoid component was significantly associated with pain relief (p < 0.001) as well as with an improvement in abduction from a mean of 92 degrees to 146 degrees (p < 0.001) and external rotation from a mean of 26 degrees to 60 degrees (p < 0.001). According to the modified Neer result-rating system, the result was excellent in forty-seven shoulders, satisfactory in twenty-seven shoulders, and unsatisfactory in twenty-one shoulders. Five patients underwent revision surgery because of component loosening (two patients), component subluxation (one patient), a fracture distal to the stem (one patient), and polyethylene wear (one patient). Glenoid periprosthetic lucency was present in sixty-nine (83%) of eighty-three shoulders at a minimum radiographic follow-up of two years. CONCLUSIONS: The data from this study suggest that total shoulder arthroplasty with a cemented metal-backed glenoid component for the treatment of osteoarthritis is associated with pain relief and improvement in motion. However, the high rate of glenoid periprosthetic lucency is concerning and requires additional follow-up and investigation. These results are not better than those that have been reported for all-polyethylene cemented glenoid components.
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