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Wang C.,Biomechanics Labs of Orthopaedics Institute | Wang C.,Tianjin Medical University | Xu G.-J.,Tianjin Hospital | Han Z.,Tianjin Hospital | And 4 more authors.
International Journal of Surgery

Objective: A systematic review of randomized controlled trials (RCTs) and non-RCTs was performed to evaluate efficacy for the reduction of postoperative blood loss and transfusion requirements of topical use of tranexamic acid in patients undergoing primary total hip arthroplasty. Method: Potential articles were identified from Medline (1966 - September 2014), Embase (1980 - September 2014), Pubmed (1980 - September 2014) and The Cochrane Central Register of Controlled Trials. Other internet databases are also searched to find trials according to the Cochrane Collaboration guidelines. Moreover, gray literatures are also selected from the reference list of the included studies. High quality randomized controlled trials (RCTs) and non-RCTs were selected. The software RevMan 5.1 was used for the mate-analysis. Results: Four RCTs and four non-RCT meet the inclusion criteria. There were significant differences in hemoglobin, total blood loss, transfusion requirements and postoperative drainage volume between TXA groups and control groups. There were no significant differences in length of stay, incidence of wound infection, deep vein thrombosis (DVT) and pulmonary embolism (PE) between treatment and control groups. Conclusions: Present meta-analysis indicates that the antifibrinolytic agent, also known as tranexamic acid, could reduce hemoglobin decline, volume of drainage, total blood loss and transfusion requirements after THA, and is not related to adverse reactions or complications such as wound infection, DVT and PE. © 2015 Surgical Associates Ltd. Source

Kuang M.-J.,Biomechanics Labs of Orthopaedics Institute | Kuang M.-J.,Tianjin Medical University | Ma J.-X.,Biomechanics Labs of Orthopaedics Institute | Wang Y.,Biomechanics Labs of Orthopaedics Institute | And 4 more authors.
International Journal of Clinical and Experimental Medicine

Objective: Perioperative pain is a serious problem that interferes with postoperative rehabilitation and hospital stays. There is no definitive evidence regarding the analgesic efficacy of celecoxib. Therefore, we conducted a meta-analysis to estimate the efficacy and safety of celecoxib for patients after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Method: Related articles were mainly searched from Medline, PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Google Scholar. Keywords “TKA OR THA OR knee replacement OR hip replacement OR arthroplasty” AND “celecoxib” in combination with Boolean operators were used to extract the studies. We select RevMan 5.3 software to conduct the meta-analysis. Results: Six randomized controlled trials are included in our meta-analysis. There were significant differences in visual analogue scale, range of motion, and mean opioid consumption comparing the celecoxib group with placebo group after TKA. However, the differences in total blood loss and postoperative nausea and vomiting were not significant between the two groups. Conclusions: Celecoxib can decrease the postoperative pain and reduce opioid consumption, as well as increasing knee joint motion. The use of celecoxib is worthy of recommendation as a standard analgesic protocol for pain treatment after TKA and THA. © 2016, E-Century Publishing Corporation. All rights reserved. Source

Kuang M.-J.,Biomechanics Labs of Orthopaedics Institute | Kuang M.-J.,Tianjin Medical University | Xu L.-Y.,Biomechanics Labs of Orthopaedics Institute | Xu L.-Y.,Tianjin Medical University | And 6 more authors.
International Journal of Surgery

Objective: Continuous femoral nerve block (CFNB) is considered the preferred analgesia after TKA. However, it may weaken quadriceps muscle strength, subsequently increasing the risk of falling. Adductor canal block (ACB) is a new sensory block technique that effectively relieves postoperative pain while preserving quadriceps strength. Thias meta-analysis was conducted to determine whether ACB of CFNB provides better pain relief and functional recovery after TKA. Method: The PubMed, Embase, Web of Science and Cochrane Library databases were comprehensively searched. Seven studies comparing ACB with CFNB in patients with TKA were enrolled in our meta-analysis. Review Manager 5.3 for Windows was used to analyse the extracted data. Results: Compared with the CFNB group, the ACB exhibited a significant decrease in visual analogue scale (VAS) score at rest within 24 h (p < 0.00001), as well as significant decreases in the length of hospital stay (P < 0.0001) and post-operative nausea (P = 0.03). ACB patients also exhibited greater improvements in ambulation ability (P = 0.01) and ambulation distance (P < 0.00001). There were no significant differences in the VAS score at rest 8 and 48 h following surgery, nor in the ambulation VAS score and opioid consumption two days following surgery. Conclusions: Compared with CFNB, ACB provides equally effective analgesia after TKA. ACB results in fast pain relief and early ambulation while decreasing post-operative nausea. ACB thus has the potential to replace CFNB as the gold standard for pain management in TKA patients. © 2016 IJS Publishing Group Ltd. Source

Jia H.,Tianjin Medical University | Zhu S.,Biomechanics Labs of Orthopaedics Institute | Ma J.,Tianjin Medical University | Wang J.,Tianjin Medical University | And 8 more authors.
Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine

Posterior lumbar structures are vital for spinal stability, and many researchers thought that laminectomy and facetectomy would lead to severe spinal instability. However, because living organisms have compensatory repair capacities, their long-term condition after injuries may change over time. To study the changes in the lumbar biomechanical stability of flexion/extension and torsion at different time points after the resection of various posterior structures, as well as to assess the capacity for self-healing, sheep that had undergone laminectomy or facetectomy were used as an experimental animal model. The injured sheep models included three groups: laminectomy only, laminectomy plus left total facetectomy, and laminectomy plus bilateral facetectomy. Eight nonoperative sheep were used as the control group. At 0, 6, 12, 24, and 36 weeks after injury, the lumbar specimens were harvested for biomechanical testing using the Instron 8874 servohydraulic biomechanical testing system. The changes in the injured lumbar spine were also analyzed through radiological examination. The lumbar stability in flexion/extension and torsion was severely decreased after the three types of surgery. After 6 weeks, the flexion/extension mechanical parameters recovered substantially; each parameter had returned to normal levels by 12 weeks and exceeded the intact group by 24 and 36 weeks. Torsional stiffness also recovered gradually over time. All injury groups demonstrated decreased intervertebral space and degeneration or even fusion in the small joints of the surgical segment or in adjacent segments. These results indicate that the body has the ability to repair the mechanical instability to a certain extent. © IMechE 2013. Source

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