Improved Early Postoperative Range of Motion in Total Knee Arthroplasty Using Tranexamic Acid: A Retrospective Analysis
J Knee Surg DOI: 10.1055/s-0038-1636914The use of tranexamic acid (TXA) in total knee arthroplasty (TKA) has become common practice. Recent literature has demonstrated a reduction in postoperative knee swelling and drain output while using TXA. Our purpose is to analyze the range of motion (ROM) following TKA in patients who received TXA compared with a control group. We hypothesize that patients treated with TXA will have improved early postoperative ROM when compared with controls. A retrospective chart review was performed for patients who underwent TKA from 2010 to 2012 performed by a single orthopaedic surgeon. Patients were stratified into three cohorts by route of TXA administration including intravenous (IV), topical, and a control group. Dependent variables analyzed included extension, flexion, and total arc ROM on each postoperative day (POD), average ROM across all three postoperative days, as well as pre-to-postoperative differences in ROM. Demographic data were recorded for each patient. A total of 174 patients were included for analysis, 75 controls and 99 receiving TXA. A significant difference was found between the treatment groups and the control for all variables (for each, p ≤ 0.002). There were no significant differences in ROM between the IV and topical TXA treatment groups (for each, p ≥ 0.558). A multivariate analysis demonstrated no significant difference between the groups in complication rate or demographic variables...
This report describes 2 cases of guided endodontics using conventional palatal access in calcified anterior teeth and discusses the applicability of this approach in cases of pulp canal calcification with apical periodontitis and acute symptoms.
The aim of the present study was to compare the immunoexpression of CD34, intercellular adhesion molecule-1 (ICAM-1), and podoplanin and the presence of mast cells with clinical, demographic, radiologic, and histologic features from periapical granulomas, periapical cysts, and residual cysts.
We present a new technique of three dimensional (3D) computed tomography (CT) guided interstitial (IS) brachytherapy (BT) and evaluate the dosimetric advantage of the current technique compared with the conventional intracavitary brachytherapy for locally advanced cervical cancer, offering a more advantageous clinical treatment approach.
Interstitial brachytherapy (ISBT) is indicated in the definitive management of intact cervical carcinoma (IN-CC) if intracavitary brachytherapy (ICRT) yields unsatisfactory dosimetry or is technically not feasible. ISBT is also the brachytherapy of choice in patients of vault carcinoma (VA-C), where it provides excellent coverage with better sparing of the organs at risk. While, studies have assessed doses to pelvic lymph nodes in ICRT, the same has not been reported in ISBT. The present study evaluates the doses to pelvic lymph node groups in patients of carcinoma cervix treated with ISBT.
Despite the fact that vaginal cylinder is a very common brachytherapy (BT) treatment and despite its apparent simplicity, the impact of dose schedules, prescription point, and treatment length are little understood. In this work we investigate the radiobiological impact of dose prescription parameters on dose distribution within a standard planning target volume (PTV) for high-dose-rate (HDR) BT vaginal cylinder treatments at a single institution. An insight on the magnitude of effects and their likely clinical relevance is given by retrospectively analyzing outcomes.
Image-guided high-dose-rate multichannel vaginal cylinder (MCVC) brachytherapy (BT) permits conformal dose delivery to a vaginal tumor while sparing surrounding organs-at-risk. Due to the proximity of the peripheral channels to the tumor and cylinder surface, the adjacent vaginal mucosa is a dose-limiting structure when using MCVC, however, specific dose-volume limitations are not well characterized. We explored vaginal dose-volume parameters in a series of consecutive patients treated with MCVC for gynecologic cancers involving the vagina.
We present a comparison between the reported dosimetry delivered by multi-fraction treatments based on a single pre-treatment MR and/or CT image with the dosimetry delivered when an additional image is acquired prior to the second fraction after implant.