We report a study of 2 surgical approaches to the knee in 42 consecutive patients undergoing a total arthroplasty. They were divided into 2 groups. In Group 1 (n=17) the knee was exposed through classic medial parapatellar arthrotomy and in Group 2 (n=25) the knee was approached through the fibers of the medial vastus. Preoperative assessment did not reveal any statistical differences between the groups, and blood loss, operation time, biochemistry values and radiographic evaluation were also similar. However, a higher number of lateral releases, a loss of knee extension and a reduced range of motion were significantly associated with classical parapatellar arthrotomy. As the number of operative or postoperative complications was not increased, we recommend the mid-vastus approach for total knee arthroplasty.Résumé Nous présentons une étude de 42 arthroplasties totales consécutives de genoux qui ont été divisées en deux groupes. Le groupe 1 (n=17) a eu une voie d'abord classique par arthrotomie antéro-interne parapatellaire et le groupe 2 (n=25) a eu un abord à travers les fibres du vastus medialis. Entre les deux groupes, il n'y a pas de différence significative entre les données pré-opératoires, la perte sanguine, le temps opératoire et l'état radiographique. Dans le groupe 1, un plus grand nombre de libé-rations externes a été nécessaire, une perte de la force d'extension a été notée ainsi qu'une diminution de l'amplitude articulaire. Comme le taux de complications opé-ratoires et postopératoires n'a pas été majoré, nous recommandons ce type d'approche à travers les fibres du vastus medialis pour l'arthroplastie totale de genou.
The literature is not conclusive on whether the use of NSAIDs is associated with anastomotic leaks after gastrointestinal cancer surgery. Also, the current evidence is equivocal regarding the effects of short-term NSAIDs on cancer recurrence after major cancer surgery. Three RCTs are being conducted to assess the impact of NSAIDs on cancer recurrence. There are no registered RCTs that are testing the hypothesis of whether the perioperative use of NSAIDs increases the rate of anastomotic leaks.
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