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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_8 | Pages 28 - 28
1 Aug 2020
Wong I John R
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To evaluate the short-term clinical outcomes of patients treated arthroscopically with chitin-based scaffolding for acetabular chondral defects in conjunction with microfracture compared to microfracture alone.

This study is a retrospective analysis of prospectively collected data. A review of charts was performed (2014–2016) on all patients who underwent hip arthroscopy and had microfracture +/− scaffolding for acetabular chondral defects, intraoperative details (lesion size, grade, labral repair/reconstruction) and postoperative complications were recorded with a minimum follow-up of 2 years. Clinical outcomes were assessed by analysing iHOT and HOS scores which were obtained pre-operatively, at six months, one year and two years post-surgery. Plain radiographs were assessed for hip osteoarthritis by Kellgren & Lawrence grading.

A total of 60 patients (microfracture=25, scaffolding=35) were included. Patients had a mean age of 36.2 years at the time of the index operation. There were no major adverse events of deep vein 36.2 years at the time of the index operation. There were no major adverse events of deep vein thrombosis, blood vessel or nerve damage, hemarthrosis or device related adverse events in both groups. Two patients were readmitted due to pain as a result of an inflammatory reaction in the scaffolding group. Both treatments of microfracture and scaffolding showed significant improvement in outcome score (iHOT) (p < 0 .001) when compared postoperative to preoperative.

Both the arthroscopic treatment of chondral acetabular defects with chitin based scaffolding and microfracture demonstrated significant improvement from their pre-operative outcomes.


Introduction

The available scoring methods and outcome analysis methods in lower extremity skeletal trauma with vascular injuries are not always specific. Biochemical parameters like venous blood lactate, bicarbonate and serum CPK (at the time of admission and serial monitoring) were measured to assess whether they supplement clinical parameters in predicting limb salvageability in lower extremity skeletal trauma with vascular injuries. Materials and methods: 74 adult patients with long bone fracture of lower limb associated with vascular injury (open and closed) were included in the study group. Patients with significant head injury (who cannot provide informed consent) and those with mangled extremities (MESS score>8) were excluded.

Methodology

Pre-operative requirement for fasciotomy was recorded. A vascular surgery consultation was obtained. CT angiography and DSA were performed if needed only. Venous blood samples from the injured limb were withdrawn for lactate and bicarbonate analysis. Serum CPK was estimated at the time of admission and repeated at 6, 12, 24, 48 and 72 hours after admission. A record was maintained about the type and duration of surgery, blood loss, type of anaesthesia used and fasciotomy in the post-operative period.