RESUMEN
BACKGROUND: The nature of posterior cruciate ligament (PCL) injuries and the scarcity of data on this issue have made reports on clinical and epidemiological features of PCL injuries valuable. We aimed to report our experiences with PCL injuries in our region. METHODS: Any patient who referred with a diagnosis of PCL rupture from 2004 to 2018 to our center, was included in this report. We evaluated pre- and postoperative outcomes and compared patients with isolated and combined (multi-ligament) PCL injuries. RESULTS: Overall, 55 patients were included in our study. Majority of patients were men (87.2%). Mean age of patients was 28.12 ± 8.53 years old. Average follow-up period was 28.83 ± 20.62 months and mean duration between trauma and surgery was 27.8 ± 38.0 months. Most common cause of PCL injury was traffic accidents (70.9%) followed by sports injuries (5.5%). Majority of patients (69.1%) had combined PCL injuries. Majority of patients underwent single tibial-double femoral tunnel reconstruction (56.4%), followed by single tibial-single femoral tunnel (34.5%) reconstruction. Allografts were used in 60% of patient. Average Cincinnati knee rating scale (CKRC) was 35.87 ± 11.4, which improved significantly after PCL reconstruction (79.45 ± 11.90, p < 0.001). Full range of motion only existed in 29.1% of patient prior to surgery, which improved after surgery (92.7%, p < 0.001). Three patients had postoperative arthrofibrosis and motion stiffness, 1 had deep vein thrombosis and 3 patients had infections. Those with isolated PCL injuries had higher pre-operative CKRS (42.05 ± 8.96 vs. 33.10 ± 11.45, p = 0.006) and lower pre-operative posterior drawer test (2.76 ± 0.43 vs. 3.1 ± 0.6, p = 0.042) compared to those with combined injuries. CONCLUSION: Today with advances in surgical techniques, considering treatment of collateral ligament injuries, use of stronger allografts and more secure fixation methods, better rehabilitation programs and early range of motion, results of reconstruction of the PCL has become very promising. Accordingly we recommend surgical treatment even for isolated PCL tears, with the goal to prevent functional deficit and to prevent degenerative arthritis.
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Reconstrucción del Ligamento Cruzado Posterior , Ligamento Cruzado Posterior , Adulto , Femenino , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Masculino , Ligamento Cruzado Posterior/diagnóstico por imagen , Ligamento Cruzado Posterior/cirugía , Rango del Movimiento Articular , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) techniques have been used for the diagnosis of bacteria in some infections. In this study, we aimed to evaluate the diagnostic accuracy of PCR for the diagnosis of prosthetic joint infections (PJI) and to identify isolated microorganisms, using the RFLP method. METHODS: During January 2015 to January 2018, patients who were suspected of having PJI after arthroplasty surgery or were candidates for revision surgery due to loosening of implant entered the study. Patients who had 1 major criterion or 3 minor criteria for PJI based on the Philadelphia Consensus Criteria (PCC) on Periprosthetic Joint Infection were considered as cases of PJI. Both culture results and PCR findings, were cross compared with results of the PCC (as the gold standard criteria). RESULTS: Overall, 76 samples were included in the study. Mean (standard deviation) age of patients was 66.72 ± 11.82 years. Overall, 57.9% of patients were females. Prevalence of PJI was 50% based on the PCC. Sensitivity, specificity, positive predictive value, negative predictive value, and general efficacy of PCR for detection of PJI was 97.4%, 100%, 100%, 97.4%, and 98.7%, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, and general efficacy of culture was 31.6%, 100%, 65.7%, 100%, and 59.4%, respectively. We isolated a broad range of bacteria using PCR-RFLP including Gram-positive cocci such as Staphylococcus sp., Streptococcus sp., and Enterococcus sp., and Gram-negative bacilli such as Enterobacteriaceae sp., Pseudomonas sp. Citrobacter sp., as well as Chlamydophila pneumonia, Stenotrophomonas maltophilia, Brucella melitensis, non-gonococcal Neisseria, Kingella kingae, Bacteroides ovatus, and Proteus mirabilis from PJI patients. CONCLUSION: Inhere, for the first time, we showed that PCR-RFLP is a powerful tool for identifying the type of bacteria involved in PJI, and can be used for follow-up of patients suspected of PJI and those with a history of antibiotic use. PCR-RFLP may be able to substantially decrease detection time of PJI among PCR-based methods, while allowing more accurate identification of the bacteria involved.
Asunto(s)
Artritis Infecciosa/diagnóstico , Prótesis Articulares/efectos adversos , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Infecciones Relacionadas con Prótesis/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Artritis Infecciosa/microbiología , Artroplastia , Bacterias/aislamiento & purificación , Femenino , Bacterias Gramnegativas , Humanos , Masculino , Persona de Mediana Edad , Prótesis e Implantes , Infecciones Relacionadas con Prótesis/microbiología , Reoperación , Sensibilidad y EspecificidadRESUMEN
INTRODUCTION: Video-assisted clinical instruction (VACID) has been found to be a beneficial teaching tool for various fields in dentistry. The aim of this interventional study was to compare the efficacy of live conventional demonstration (CD), video teaching, and VACID (video with explanation) methods in teaching of root canal treatment to undergraduate dental students. METHODS AND MATERIALS: Forty-two undergraduate senior dental students participated in this study. The students experienced this course for the first time and were randomly divided into three groups (n=14). Group A attended live CD on a patient; group B watched a professionally produced demonstration video without any verbal explanation during 1 h; and finally group C watched the same video alongside live explanation by a mentor during the 1.5 h (VACID). The whole process was performed by an experienced endodontist on maxillary central incisors. All of The students carried out a multiple choice question exam to evaluate their comprehension. The mean score of the experimental groups were compared using ANOVA test and multiple comparisons were carried out with Tamhane test. The level of significance was set at 0.05. RESULTS: There was significant difference among three groups according to the ANOVA test (P<0.05). Group VACID had the highest mean scores. There was significant difference between the groups VACID and VT (P=0.011); no significant differences were found in other inter-group comparisons. CONCLUSION: According to the results, VACID may improve the quality of endodontic training in undergraduate dental students.