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Register a new userThromboprophylaxis after Primary Total Knee Replacement
التمييع الوقائي بعد تبديل مفصل الركبة البدئي
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يعد معدل الانصمام الوريدي الخثاري غير مقبول دون علاج وقائي، و قد أظهر التصوير الوريدي الظليل أن نسبة الخثار الوريدي العميق بعد تبديل مفصل الركبة يصل إلى 40-84 %، و نسبة الصمة الرئوية تصل إلى 1.5 - 10 % و ذلك دون علاج وقائي . و لكن على الجراحين الموازنة بين الحاجة إلى التمييع الوقائي و الحاجة لتجنب الاختلاطات النزفية. هدف هذا البحث هو دراسة واقع التمييع الوقائي بعد تبديل مفصل الركبة البدئي في مشفى المواساة الجامعي ، بقصد تحسين نتائجنا و التقليل من الاختلاطات.
The rate of venous thromboembolism is unacceptable without prophylaxis. Venographic studies of patients without prophylaxis show that the deep vein-thrombosis rates range from 40-84% after total knee replacement, and rates of pulmonary embolism range from 1.5-10%. Surgeons must balance the need for thromboprophylaxis with the need to avoid bleeding complications. The purpose of this study is to evaluate the status of thrombo prophylaxis after primary total knee replacement in ALMouassat university hospital, and to improve our outcome in future, to get better results and fewer complications.
References used
Agu 0, Hamilton G, Baker D . Graduated Compression Stockings in the Prevention of Venous Thromboembolism. Br. J. Surg., 1999;86:992-1004
Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW. Prevention of Venous Thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest, 2008; 133(6 Suppl): 381S-435S
Sheppeard H, Henson J, Ward DJ, O'Connor BT . A clinicopathological study of fatal pulmonary embolism in a specialist orthopaedic hospital. Arch. Orthop. and Traumat. Surg., 1981;99: 65-71
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Background& Objective: The acetabular bone deficiency secondary to acetabular fractures presents a
complex clinical problem and a big challenge to the orthopedic surgeons due to the technical difficulties
related to this deficiency, considering tha
t significant number of patients treated either surgically or
without surgery will require T.H.A in the future.
The purpose of our study was to determine the outcome of T.H.R performed in patients with a history of
acetabular fracture.
Materials & Methods: We performed T.H.R in 21 patients with previous acetabular fractures in Al-Assad
Hospital between2004-2009prespectively, these cases were divided into 3 groups:
-first group formed of 7 patients were treated conservatively. Second group formed of 9 patients did an
open reduction and internal fixation by screws and plates.
-Third group formed of 5 elderly patients with fresh acetabular fractures and were treated primarily by a
total prosthesis with use a reinforcement Muller ring .
For the clinical evaluation of our cases we used the modified Harris Hip Score Scale and for the
radiological evaluation we used the Delee and Charnley scale system .
Results: Our overage Harris Hip Score was 83.(80 for the first group, 86 for the second group, and 83 for
the third group).
-No complications were encountered intraoperative, in the early postoperative period one case developed
superficial wound infection and treated by repeated dressing and antibiotic, there was one case of D.V.T
on the 4th day treated by rest and anticoagulant, and one case developed loosening of acetabular
component 8 months after T.H.A and underwent to revision.
Conclusion: T.H.R in acetabular fractures despite the difficulties faced during the procedure is a safe and
effective way to salvage the hip when secondary osteoarthritis develops, open reduction and internal
fixation of acetabular fractures may have benefits even if it fails to prevent posttraumatic arthritis
.Furthermore the clinical results of T.H.R after surgical treatment of acetabular fractures are better than
it after conservative treatment of these fractures.
Reinforcement ring is an ideal solution when the decision of T.H.R is taken as a primary treatment of
acetabular fractures depending on the indications described by Joly.
This study includes ٨٠ cases of total knee Arthroplasty, They
were treated in Al-Moassat Hospital during the years ٢٠٠٠-
٢٠٠١.
Idiopathic primary osteoarthrihis was the main reason for total
knee Arthroplasly. Some cases of Rheumatoid arthritis w
ere
observed too.
The short term chinicaln gools of total arthoplasty include
restoration of the normal activity of the limb and pain relief ,
which can be obtained under the proper surgical condition,
and requirements, supported by better understanding of the
biomechanics of the knee joint and good rehabilitation there
after.
The aim of this clinical study was to investigate the intraocular pressure (IOP) reduction after selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG). The research has been done in Alassad Hospital, Tishreen unive
rsity, Lattakia, from Feb 2009 to Feb 2011. Fifty eyes with uncontrolled POAG were treated with a frequency doubled, Q-switched Nd:YAG laser (532 nm).The pattern of treatment was applying approximately 50 burns to 180 degrees of the trabecular meshwork at energy levels ranging from 0.40– 0.92 mJ per pulse. After SLT eyes were maintained with the identical hypotensive medical therapy as that before treatment. IOP was measured before treatment, 1 and 7 days after treatment and 1, 3, 6 and 12 months after treatment. The mean pretreatment IOP was 22.48 (SD 1.84) mmHg. At the end of 1 month follow-up period the mean reduction of IOP was 4.86 mmHg (21.6%); after 3 months the mean reduction was 5.66 mmHg (25.2%); after 6 months the mean reduction of IOP was 5.06 mmHg (22.5%); at the end of 12 months follow-up period the mean reduction was 4.92 mmHg (21.9%). It can be concluded that SLT presents a new and effective method of IOP reduction in the treatment of POAG.
Background: Many options are available for the treatment of synovitis or target joint in hemophilia to prevent recurrent bleeding and further joint destruction when conservative therapy fails such as chemical synovectomy. Chemical synovectomy with Ri
fampicin has been used for many years in several clinical trials with good results and without serious complications.
Objective :evaluate the safety and the efficacy of this procedure in the Syrian hemophilic patients.
Conclusion: chemical synovectomy with rifampicin is a good treatment, cheap and safe in hemophilic patients.
The aim of this paper is to study the changes of knee movement during walking for
patella femoral pain using flexible electro-goniometry, This is very important for gait research
and stability of knee, the start and end of the gait cycle were deter
mined by foot sensors, A
program was designed for signal processing of the data by Mat lab, Testes were carried out at
Hamish hospital in Damascus, Subjects were divided into two groups: 46 normal subjects and
21 patients. Results showed that the lesion effect on knee movement which the values of knee
flexion are less than normal, In the stance phase it is noted that the knee cancels its first
flexion, and In swing phase it noted that the decrease in knee flexion. It was also noted that
these values were varied between the patient tested.
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