RESUMEN
This study was designed to assess the use of platelet-rich plasma (PRP) during primary total knee arthroplasty (TKA). The authors hypothesized that this would result in less blood loss and greater hemoglobin and hematocrit levels at discharge and would potentially decrease the length of hospital stay. Leukocyte rich PRP was used during the procedure and at wound closure. Two surgeons performed all procedures in a similar fashion. Two different TKA implants were used. Each surgeon used the same implant throughout the study. A limited medial parapatellar approach was used and drains were used at closure. No tranexamic acid preparations were used. Continuous passive motion machines were used in all patients during their hospital stay. A total of 102 consecutive TKAs were performed. The study group (n=46) consecutively received the PRP injections during the TKA, whereas the control group (n=47) did not. Hemoglobin and hematocrit levels were obtained pre- and postoperatively. Estimated blood loss was recorded during surgery, and the auto-collection reinfusion drain system output was measured. The length of hospital stay was collected and recorded. The study showed that hemoglobin and hematocrit levels were not different when comparing study and control groups. Age and sex differences were insignificant. Finally, no statistical difference was seen for the estimated blood loss and hospital stay between the 2 groups. Platelet-rich plasma use during TKA does not decrease hospital stay or reduce estimated blood loss in the perioperative period.
Asunto(s)
Artroplastia de Reemplazo de Rodilla/métodos , Pérdida de Sangre Quirúrgica/prevención & control , Articulación de la Rodilla/cirugía , Osteoartritis de la Rodilla/cirugía , Plasma Rico en Plaquetas , Anciano , Estudios de Casos y Controles , Drenaje/métodos , Femenino , Hematócrito , Hemoglobinas/análisis , Humanos , Inyecciones , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
A knowledge of neck strength is important for developing conditioning protocols and for evaluating the relationship between neck strength and head and neck injury, but very few studies have examined neck strength in relationship to athletic participation. The purpose of this study was to quantify isometric neck strength in collegiate and high school athletes. We hypothesized that (a) male athletes would have significantly greater neck strength than females; (b) collegiate athletes would be significantly stronger than high school athletes; and (c) neck strength would vary significantly with head posture. A total of 149 subjects participated (77 men and 72 women; 90 college and 59 high school level). Flexion, extension, and lateral flexion neck strength were measured in neutral and rotated head and neck postures. Neck strength varied significantly according to participants' sex, age, and posture (p < 0.05). Male college students were stronger than those in all other groups (female college students, male high school students, and female high school students). The average female neck strength was 61, 54, and 56% of the average male neck strength for extension, flexion, and lateral flexion, respectively. High school athletes' neck strength was 75, 68, and 65% of collegiate athletes' neck strength for extension, flexion, and lateral flexion, respectively. On average, neck strength was the greatest for extension compared with other force directions. The subjects showed large variation in neck strength with posture, but in general, there were no consistent trends among the subjects. This finding suggests that those whose neck strength was considerably lower in nonneutral postures may consider training to increase strength in rotated postures. These data provide important baseline information for future studies evaluating injury risk or training protocols.