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World Journal of Orthopedics 2011年第7期2卷 57-66页

作者： Nelson A Royall Emily Farrin David P Bahner Stanislaw PA Stawicki Department of Emergency Medicine The Ohio State University Medical CenterColumbusOH 43210United States Department of Orthopaedics The Ohio State University Medical CenterColumbusOH 43210United States Department of Surgery Division of Critical CareTrauma and BurnThe Ohio State Unviersity Medical CenterColumbusOH 43210United States

Traditionally performed by a small group of highly trained specialists,bedside sonographic procedures involving the musculoskeletal system are often delayed despite the critical need for timely diagnosis and *** to this limitation,a need evolved for more portability and accessibility to allow performance of emergent musculoskeletal procedures by adequately trained non-radiology *** emergence of ultrasound-assisted bedside techniques and increased availability of portable sonography provided such an opportunity in select clinical *** review summarizes the current literature describing common ultrasound-based musculoskeletal ***-depth discussion of each ultrasound procedure including pertinent technical details,indications and contraindications is *** the limited amount of prospective,randomized data in this area,a substantial body of observational and retrospective evidence suggests potential benefits from the use of musculoskeletal bedside sonography.

关键词： Musculoskeletal ultrasound-guided procedures arthrocentesis Tendon injection Articular injection Fluid collection Abscess drainage Foreign body removal

Internal derangement of temporomandibular joint: role of arthocentesis with steriod

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Plastic and Aesthetic Research 2014年第1期1卷 29-32页

作者： Altaf Hussain Malik Department of Oral and Maxillofacial Surgery Govt Dental CollegeUniversity of KashmirHazratbalSrinagar 190006J&KIndia.

Aim:The aim of this study was to compare the efficacy of arthrocentesis with arthrocentesis plus steroid in the treatment of temporomandibular joint(TMJ)internal ***:Nine males and 11 females aged 17–39 years were enrolled in the *** patients were complaining of limited mouth opening and TMJ *** was performed under aseptic *** patients were clinically evaluated before the procedure,and 1 week and 6 months after the *** of TMJ pain and maximal mouth opening was recorded at each follow-up ***:Both groups showed significant improvement in mouth opening and a reduction in pain scores in the postoperative period;however,the addition of steroid did not improve the overall outcome of the ***:arthrocentesis is a simple and safe procedure for patients with internal derangement of the TMJ with closed ***,the outcome was not improved by the addition of steroid.

关键词： arthrocentesis internal derangement steroid temporomandibular joint

Synovial White Cell Count in the Diagnosis of Septic Arthritis: Are Current Diagnostic Practices Appropriate?

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Open Journal of Orthopedics 2015年第12期5卷 400-403页

作者： Kalpa Perera Department of Surgery Eastern Health Box Hill Australia

Introduction & aims: Septic arthritis is an emergency, potentially causing irreversible joint destruction and disability. Synovial WCC and polymorphonuclear cell percentage are the best predictors of septic arthritis likelihood. Yet, synovial white cell and differential count are not routinely assessed. We aim to investigate the incidence of failure to perform these tests, and to develop correct synovial fluid analysis practices. Method: This is a retrospective analysis of native joints having undergone arthrocentesis for suspicion of septic arthritis at Box Hill Hospital (BHH) during September 2011 and September 2013 inclusive. Recruitment was from the Eastern Health Decision Support Service (DSS), a database compiled from all systems within Eastern Health, of which BHH is a member. The study was limited to large joints, including hip, knee and shoulder. All prosthetic joints were excluded from the patient population. All patient histories were examined for suspicion of septic arthritis and subsequent arthrocentesis. Pathology records were accessed to determine incidence of cell count and differential. Results: One hundred and thirty-six cases of joint aspirations were identified within the time frame, of which sixty-seven fitted our criteria for evaluation. All but two cases were delivered using the DSS, which was limited to data compiled only until June 2013. The two remaining cases were identified with a manual search of the radiology and pathology databases from June to September 2013. 22 of the 67 joint aspirates studied did not have a cell count carried out. Four of these 22 cases had a diagnosis of septic arthritis. In five aspirates, there was a failure to confirm a definite diagnosis and they were thus conservatively treated as a septic joint. The remaining acute joints in which no cell count was done were gout (7 cases), pseudogout (5 cases) and rheumatoid arthritis (1 case). Cell counts were not routinely detected for a variety of reasons. Eleven aspirat

关键词： Septic Arthritis arthrocentesis Synovial White Cell Count

The Effect of Tramadol Hydrochloride In-traarticular Injection on IL-6 Level in Patients with Tempromandibular Joint Internal Derangement

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Pain Studies and Treatment 2015年第4期3卷 31-37页

作者： Yasser M.El-Gerby Mohammed A.El-Sholkamy Amal F.Abdelhai Eman A.Elsharrawy Faculty of Dentistry Suez Canal UniversityIsmailiaEgypt Faculty of Medicine Suez Canal UniversityIsmailiaEgypt

Purpose: This study was conducted to detect IL-6 in synovial fluid in cases with TMJ internal derangement. Patients & Methods: This study was conducted on forty patients ASA class I with TMJ Internal derangement. All patients had been subjected to arthrocentesis. The synovial fluid was collected before wash and lavage was done for the affected joint. Then, the selected patients were divided randomly into two equal groups, group I: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml, tramadol hydrochloride. Group II: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml. sodium hyaluronate. Another synovial fluid sample was aspirated after one month. The interlieukin-6 receptors in the aspirated synovial fluid were measured using humans IL-6 enzyme-linked immunosorbent assay. Results: IL-6 was detected in the synovial fluid of joints with internal derangement. During follow up assessment of IL-6, the maximum decrease in IL-6 level was in the patients of group I who subjected to arthrocentesis with tramadol injection, as the mean IL-6 was (4.93 ± 1.36) followed by the patients of group II who subjected to arthrocentesis with sodium hyaluronate injection where the mean IL-6 level was (6.88 ± 1.76). There were significant p-value = (P = 0.000). Conclusions: It had been concluded that the detection of IL-6 in the synovial fluid of joints with internal derangement considered an indicator for inflammatory reaction in the joint and also the efficacy of arthrocentesis with tramadol suggested its anti-inflammatory effect.

关键词： arthrocentesis Sodium Hyaluronate IL-6 Tramadol Hydrochloride

Treatment of chronic recurrent dislocation of temporomandibular joint by autologus blood injection

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Plastic and Aesthetic Research 2016年第1期3卷 121-125页

作者： Syed Sayeed Ahmed Md.Kalim Ansari Department of Oral and Maxillofacial Surgery Dr.Ziauddin Ahmed Dental CollegeAligarh Muslim UniversityAligarh 202002India

Aim:The aim of this study was to evaluate the efficacy of autologus blood injection in the management of recurrent temporomandibular joint(TMJ)***:A total of 11 patients,4 males,7 females,mean age of 58.6 years and suffering from recurrent dislocation of TMJ,were included in the *** all the patients the procedure included anesthesia-local or sedation,arthrocentesis which was followed by autologous blood injection in the upper joint *** peri-articular tissues were also infiltrated with autologous *** procedure advice included restricted mouth activity and liquid diet for a ***:The results indicate that success rate of treatment of recurrent dislocation of TMJ is 72.8%which can be considered as *** recurrence was noticed in 27.2%cases after one year follow ***:Autologus blood injection is an effective,simple,non-invasive,and safe procedure for treatment of recurrent dislocation of TMJ and can be performed on outpatient basis.

关键词： Subluxation recurrent dislocation arthrocentesis temporomandibular joint autologous blood

Management of periprosthetic infections

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World Journal of Clinical Infectious Diseases 2017年第2期7卷 11-20页

作者： Félix Vilchez-Cavazos Gregorio Villarreal-Villarreal Victor Pe?a-Martinez Carlos Acosta-Olivo Orthopedics and Trauma-tology Hospital Universitario "Dr.José E.Gonzalez"

Periprosthetic joint infection(PJI) is considered one of the most challenging complications compromising patient health and is considered an economic *** all strategies PJI prevalence is between 1%-2%. Considerable efforts have been investigated in the past decade to diminish or erradicate PJI prevalence. This article manages the definition of PJI and the new major and minor criteria from Parvizi et al Then a scientific analysis of every minor and major criteria. Multidisciplinary management is reccommended according to guidelines. A numerous of surgical options exist each and everyone with its indications,contraindications and specific antibiotic therapy regimen. Surgical options are:(1) irrigation and cleaning with retention of the prosthesis with a success rate 0%-89%;(2) single-stage revision surgery with a succes rate of > 80%; and(3) two-stage revision surgery(authors preferred method) with a succes rate of 87%. Radical treatment options like arthrodesis and amputation are reserved for specific group of patients,with a succes rate varying from 60%-100%. The future of PJI is focused on improving the diagnostic tools and to combat biofilm. The cornerstone of management consists in a rapid diagnosis and specific therapy. This article presents the most current diagnostic and treatment criteria as well as the different surgical treatment options depending on the type of infection,bacterial virulence and patient comorbidities.

关键词： Periprosthesic joint infection Arthroplasty arthrocentesis Infection Diagnosis Staphylococcus aureus