Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
BACKGROUND: Neurological complications in sciatic nerve (SN) after a total hip replacement (THR) are observed in 0.93.2% of cases in patients with arthrosis deformans and age-related morphologic changes in SN. These cause the need for SN evaluation before THR. This research was aimed at the evaluation of the initial SN capacity with electrophysiological findings in patients with arthrosis deformans of the hip. MATERIALS AND METHODS: Electroneuromyography (ENMG) was used to evaluate fibular and tibial nerves M-responses as well as F-waves in 66 patients with dysplastic coxarthrosis and 12 patients with posttraumatic coxarthrosis. The findings were compared to those of the controls. RESULTS: Changes in ENMG findings for fibular nerve in 49 patients with dysplastic coxarthrosis were bilateral and showed significant difference only from the norm. In 19 of 66 cases (27.9%) low M-responses (р 0.02) were found in the side subject to THR. In 87.3% of cases, the signs of a decrease in the conductivity of proximal segments of the tibial nerve were revealed. In patients with posttraumatic coxarthrosis, the significant decrease in ENMG findings from both fibular and tibial nerves was observed in the affected side, they made up just 42-50% of those in the opposite side. Asymptomatic progress of denervation damage in hip and tibia muscles sometimes required needle EMG to fund the signs of motor innervation disorder. A-waves revealed in 65% of patients suggested local damage to one or both portions of SN. CONCLUSION: ENMG findings in patients with dysplastic arthrosis of the hip enabled revealing of the signs of neuropathy before surgeries and decreasing the risk of neurologic post-surgery complications.
BACKGROUND: Neurological complications in sciatic nerve (SN) after a total hip replacement (THR) are observed in 0.93.2% of cases in patients with arthrosis deformans and age-related morphologic changes in SN. These cause the need for SN evaluation before THR. This research was aimed at the evaluation of the initial SN capacity with electrophysiological findings in patients with arthrosis deformans of the hip. MATERIALS AND METHODS: Electroneuromyography (ENMG) was used to evaluate fibular and tibial nerves M-responses as well as F-waves in 66 patients with dysplastic coxarthrosis and 12 patients with posttraumatic coxarthrosis. The findings were compared to those of the controls. RESULTS: Changes in ENMG findings for fibular nerve in 49 patients with dysplastic coxarthrosis were bilateral and showed significant difference only from the norm. In 19 of 66 cases (27.9%) low M-responses (р 0.02) were found in the side subject to THR. In 87.3% of cases, the signs of a decrease in the conductivity of proximal segments of the tibial nerve were revealed. In patients with posttraumatic coxarthrosis, the significant decrease in ENMG findings from both fibular and tibial nerves was observed in the affected side, they made up just 42-50% of those in the opposite side. Asymptomatic progress of denervation damage in hip and tibia muscles sometimes required needle EMG to fund the signs of motor innervation disorder. A-waves revealed in 65% of patients suggested local damage to one or both portions of SN. CONCLUSION: ENMG findings in patients with dysplastic arthrosis of the hip enabled revealing of the signs of neuropathy before surgeries and decreasing the risk of neurologic post-surgery complications.
Introduction. Direct oral anticoagulants (DOAC) rivaroxaban and apixaban have significantly reduced the risk of developing venous thromboembolic complications (VTEC). However, the use of DOAC may be associated with a higher risk of bleeding, especially actual in patients after total hip arthroplasty (THA).Material and methods. We enrolled 38 patients with moderate osteoarthritis of the hip joints undergoing THA. The mean age of patients was 58 (33; 85) years. All the patients received rivaroxaban or apixaban in the doses specified by Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications (VTEC). Retrospectively, in the postoperative period, the patients were divided into two groups: Group 1 — 31 patients (20 women and 11 men), who had no hemorrhagic complications after hip replacement; and Group 2 — 7 patients (4 women and 3 men) who experienced hemorrhagic events in the form of hematomas in the wound area. Laboratory tests were performed for all patient baseline (1st day of hospitalization), after surgery (1st day after THA), and on the 7th day after THA. Analyses included the determination of hemostasis parameters (INR, aPPT, fibrinogen, D-dimer), hematological (HGB, PLT, RBC) and biochemical parameters (calcium, ionized calcium, serum iron, hs-CRP).Results. The analysis of biochemical parameters in patients with hemorrhagic complications revealed a significant increase of fibrinogen (p=0,023) compared with uncomplicated cases. Serum iron concentration in men with hemorrhagic complications in the postoperative period was significantly lower than in patients without complications. In patients with hemorrhagic complications, the ionized calcium was lower (p=0,032) than in patients without complications, but within the reference values. The hs-CRP concentration in the group with hemorrhagic complications was twice higher than in the group without complication and eight times above the reference values.Conclusion. The concentration of iron in the blood serum in men below 11 mmol/l and a slight hyperfibrinogenemia of 4.65 g/l in all the patients are the risks of developing hematomas in the area of surgery. These parameters should be used to predict the risk of hemorrhagic complications in patients before THA and recommended for control before the surgery and on the 1st day after THA (hs-CRP).
Изменение возрастной структуры населения планеты ведет к увеличению числа гериатрических пациентов, нуждающихся в эндопротезировании крупных суставов. Возрастная слабость, потеря мышечной массы, дефицит тестостерона, лишняя масса тела, наличие сопутствующих заболеваний делают процесс восстановительного лечения трудоемким и приводят к различным осложнениям. Цель работы — оценка эффективности модернизированной методики лечебной физкультуры на 1-м этапе восстановительного лечения у пациентов пожилого и старческого возраста с остеоартритом тазобедренного сустава. Все пациенты получали стандартную комплексную терапию, включающую ортопедические методы лечения, медикаментозную терапию, миостимуляцию, массаж, мануальную терапию. Пациентам основной группы дополнительно к традиционному комплексу была добавлена методика лечебной физкультуры по заявленному способу и рекомендовано ношение компрессионного трикотажа (чулки) во время выполнения упражнений. Преимуществом методики стало отсутствие осложнений и побочных эффектов, что является важной составляющей по сравнению с другими способами восстановительного лечения. Минимальные затраты, общедоступность и автономность выполнения упражнений, высокие результаты, достигнутые в процессе лечения, подтверждают ценность и важность создания подобных техник и для других крупных суставов. Разработанная методика лечебной физкультуры показала свою эффективность и востребованность у пожилых пациентов и может быть рекомендована к применению у разных групп населения как метод восстановительного лечения остеоартрита тазобедренного сустава. Changes in the age structure of the planet’s population are leading to an increase in the number of geriatric patients requiring replacement of large joints. Age-related weakness, loss of muscle mass, testosterone deficiency, excess weight, and the presence of concomitant diseases make the process of rehabilitation treatment labor-intensive and lead to various complications. The purpose of our work was to evaluate the effectiveness of the modernized method of physical therapy at the first stage of rehabilitation treatment in elderly and senile patients with osteoarthritis of the hip joint. All patients received standard complex therapy, including orthopedic treatment methods, drug therapy, myostimulation, massage, and manual therapy. For patients in the main group, in addition to the traditional complex, the method of physical therapy according to the stated method was added and it was recommended to wear compression hosiery (stockings) while performing the exercises. The advantage of the technique is the absence of complications and side effects, which is an important component compared to other methods of restorative treatment. Minimum costs, general availability and autonomy of performing exercises, high results achieved during the treatment process confirm the value and importance of creating similar techniques for other large joints. The developed method of physical therapy has shown its effectiveness and relevance among elderly patients and can be recommended for use among different population groups as a method of restorative treatment of osteoarthritis of the hip joint.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.