BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh sweling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh sweling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

Adolescent ; Adult ; Bursitis ; diagnosis ; therapy ; Child ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Pharyngeal Diseases ; diagnosis ; therapy ; Young Adult

Diagnostic Errors ; Hoarseness ; diagnosis ; Humans ; Hypothyroidism ; diagnosis

Adult ; Child, Preschool ; Female ; Humans ; Male ; Otorhinolaryngologic Neoplasms ; diagnosis ; surgery ; Teratoma ; diagnosis ; surgery

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mycoses ; diagnosis ; drug therapy ; Nasopharyngitis ; diagnosis ; drug therapy ; Nasopharynx ; microbiology ; Retrospective Studies ; Young Adult

Bronchi ; surgery ; Child ; Child, Preschool ; Endoscopy ; Female ; Foreign Bodies ; surgery ; Humans ; Infant ; Male ; Trachea ; surgery ; Video-Assisted Surgery

Cysts ; congenital ; diagnosis ; surgery ; Female ; Humans ; Infant, Newborn ; Male ; Tongue Diseases ; congenital ; diagnosis ; surgery

Objective To evaluate the efficacy of interventional therapy of occlusive lesion in iliaco- femoral arteries. Methods During Feb 2001 to Feb 2006, 42 patients (30 male and 12 female) with arterial occlusive lesions in iliac artery and/or femoral artery accepted interventional therapies. The interventional therapeutic process included local thrombolytic therapy through endoarterial catheter, artery recanalization by guide wire, pereutaneous transluminal angioplasty (PTA) and stent. After interventional operation, patients were administrated anticoagulant and antibiotics one week. Follow-up interval ranged 2 years. Wilcoxon test and t test were used for statistics. Results Immediate technical successful rate was 97.6% (41/42),the secondary technical success rate was 100.0% (42/42). The arterial occlusions were resolved successfully (local thrombolytic therapy in 26 cases, recanalization by guide wire in 31 cases, PTA in 33 cases and 60 stents in 31 cases). There were no severe complications (such as angiorrhexis, perforation) during interventional procedure. The symptoms of lower limb ischemia were palliated or vanished in all patients after interventional therapy. The ankle-brachnial index(ABI) of diseased extremities increased from pre-operation 0.34±0.14 to past-operation 0.65±0.10 (t=25.924, P <0.01 ). During the follow-up, 11/42 (26.2%) iliac or femoral artery (treated with local intra-arterial thrombolysis, PTA and stent) occurred restenosis. After PTA and stenting, the restenosis arteries became fluent successfully. The primary patency rate was 92.8% (39/42)and the secondary patency rate was 100.0% (42/42)1 year after the procedure. Two years after the procedure, the primary patency rate was 71.4% (30/42) and the secondary patency rate was 97.6% (41/42). Conclusions Interventional therapy (including local thrombolysis, recanalization, PTA and stent) is an effective and safe therapy for occlusive lesion in iliaco- femoral arteries.

Objective To explore the expressions of matrix metalloproteinases-1(MMP-1) and tissue inhibitor of metalloproteinase-1(TIMP-1) in sternomastoid muscle and explore the pathogenesis of sternomastoid muscle fibrosis in congenital fibra muscular torticollis in children.Methods The hyperplastic state of collagen fiber were determine by Masson collagen stainning method and muscular torticollis and fibra torticollis was differed,obtained 22 cases of the fibra torticollis group.Immunohistochemical method was used to determine the expression of MMP-1 and TIMP-1 in sternomastoid muscle of fibra torticollis and compared them with 6 cases of control group.Results By the immunohistochemical method,the expression of MMP-1 in the experiment group significantly decreased than that in control group(P0.05).Conclusion In congenital fibra torticollis,the sternomastoid muscle fibrosis is related to the decrease of MMP-1.

Antihypertensive Agents ; therapeutic use ; Humans ; Hypertension ; therapy ; Practice Guidelines as Topic