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BACKGROUND: Because the single percutaneous kyphoplasty for treating Kummell’s disease brought the uneven distribution and displacement of bone cement. Current research has recommended a posterior short-segmental fixation combined with vertebra cement augmentation for Kummell’s disease. OBJECTIVE: To evaluate the effectiveness and safety of percutaneous kyphoplasty or posterior short-segmental fixation combined with vertebral body bone cement augmentation for Kummell’s disease using meta-analysis. METHODS: PubMed, the Cochrane Library, Web of Science database, EMBASE, Chinese biomedical literature database, China National Knowledge Infrastructure, VIP and Wanfang database were retrieved for randomized controlled trials, case-control studies and cohort studies regarding percutaneous kyphoplasty and posterior short-segmental fixation combined with vertebra bone cement augmentation (posterior spinal fixation + bone cement) for Kummell’s disease. The retrieval period was from the database establishment to February 1, 2020, and the retrieval languages were Chinese and English. All the retrieved literature was screened according to inclusion and exclusion criteria by two reviewers. NOS scale was used to evaluate the literature quality, and then Review Manager 5.3 software was used for meta-analysis. RESULTS AND CONCLUSION: (1) Four articles were finally included, with 200 patients, including 108 in the percutaneous kyphoplasty group and 92 in the posterior spinal fixation + bone cement group. (2) Meta-analysis showed that operation time was significantly shorter and intraoperative blood loss was less in the percutaneous kyphoplasty group than in the posterior spinal fixation + bone cement group [MD=-82.83, 95%CI(-144.43, -21.24), Z=2.64, P=0.008; MD=-204.44, 95%CI(-210.97, -197.92), Z=61.43, P < 0.000 01]. Incidence of perioperative complications was lower in the percutaneous kyphoplasty group than in the posterior spinal fixation + bone cement group [OR=0.15, 95%CI(0.03, 0.91), Z=2.07, P=0.04]. Incidence of bone cement leakage was higher in the percutaneous kyphoplasty group than in the posterior spinal fixation + bone cement group [RR=1.99, 95%CI(1.03, 3.88), Z=2.03, P=0.04]. There were no significant differences in visual analogue scale score, Oswestry disability index and kyphosis angle between the two groups in the last follow-up (P > 0.05). (3) The results suggest that percutaneous kyphoplasty and posterior spinal fixation + bone cement are effective and safe in the treatment of Kummell’s disease. Percutaneous kyphoplasty can reduce the operation time, intraoperative blood loss and perioperative complications. The two methods have their own advantages and disadvantages, which should be selected by clinicians according to the individual situation of patients [ABSTRACT FROM AUTHOR]

BACKGROUND: Tranexamic acid can effectively reduce the blood loss of total knee or hip arthroplasties. Tranexamic acid can be administered in a variety of ways; however, there is still much controversy about the best use of tranexamic acid. OBJECTIVE: To compare the efficacy and safety between oral and intravenous tranexamic acid for blood loss after total knee and hip arthroplasties. METHODS: Randomized controlled trials concerning oral tranexamic acid and intravenous tranexamic acid for reducing blood loss after total knee and hip arthroplasties were retrieved from PubMed, Cochrane Library, Embase and Web of Science databases from inception to May 2019. The data were extracted for the methodological quality. Then meta-analysis was conducted by Revman 5.3 software. RESULTS AND CONCLUSION: Nine randomized controlled trials involving 1 080 cases were included. The results of this meta-analysis showed that there were no significant differences in total blood loss [MD=1.43, 95%CI(-40.02-42.88), P=0.95], postoperative hemoglobin decline [MD=-0.03, 95%CI(-0.11-0.05), P=0.45], transfusion rate [RR=0.91, 95%CI(0.55-1.49), P=0.70], deep vein thrombosis rate[RR=0.43, 95%CI(0.11-1.64), P=0.22], or hospitalization time [MD=0.00, 95%CI(-0.03-0.03), P=0.93] between two groups. These results indicate that oral tranexamic acid shows comparable efficacy to that of the intravenous forms after total knee and hip arthroplasties. However, due to the low number and limited quality of included studies, more randomized controlled trials with large samples should be rigorously designed to verify the conclusion． [ABSTRACT FROM AUTHOR]

BACKGROUND: Soft silicone silver ion dressing, a kind of high molecular weight organic compound prepared with Safetac technology, has the characteristics of anti-infection, good permeability and good air permeability. It can provide a good moist environment for wound healing. OBJECTIVE: To evaluate the effectiveness of soft silicone silver ion dressings in repairing deep II degree and milder bum wounds. METHODS: A computer-based retrieval of CNKI, VIP, WanFang, CBM, PubMed, Embase and Web of Science databases was performed. The randomized controlled trials conceming soft silicone silver ion dressing for repairing deep II degree and milder bum wounds were selected. The treatment group was treated with a single soft silicone silver ion dressing, or a soft silicone silver ion dressing combined with conventional treatment, or combined with other treatments. The control group was treated with conventional treatment, or other treatments, or placebo. After screening, data extraction and quality evaluation, meta-analysis was performed using Review Manager 5.3 software. RESULTS AND CONCLUSION: (1) Eleven articles were included, involving 784 patients, 381 patients in the treatment group and 403 patients in the control group. (2) The results of meta-analysis showed that the bum wound healing rate in the treatment group was higher than that in the control group [OR=11.56, 95%Cl (9.60, 13.53), P < 0.000 01; OR=13.29, 95%Cl (7.54, 19.04), P < 0.000 01; OR=4.10, 95%Cl (2.28, 5.93), P < 0.000 1; OR=1.17, 95%Cl (0.42, 1.93), P=0.002] at 7, 14 and 21 days, and the last measurement. The healing time of bum wounds in the treatment group was shorter than that in the control group [OR=-2.81, 95%Cl (一3.49, -2.12), P < 0.000 01]. The degree of pain in bum wounds in the treatment group was lower than that in the control group [OR=0.38, 95%Cl (-0.53,一0.24), P < 0.000 01]. There was no significant difference in the positive rate of bacterial culture on wound surface [OR=1.16, 95%Cl (0.47, 2.85), P=0.74], bum wound infection [OR=1.44, 95%Cl (0.47, 4.41), P=0.52], dressing frequency [OR=-8.04, 95%Cl (-18.82, 2.74), P=0.14], wound treatment cost [OR=-98.26, 95%Cl (-272.91, 76.40), P=0.27] and adverse reaction [OR=0.61, 95%Cl (0.31, 1.20), P=0.15] between treatment and control groups. (3) These results show that the application of soft silicone silver ion dressing on deep II degree and milder bum wounds can improve wound healing rate, shorten wound healing time and alleviate pain. [ABSTRACT FROM AUTHOR]

BACKGROUND: At present, platelet-rich plasma has been used in bums, plastic surgery, surgery and orthopedics. However, due to the different standards for platelet-rich plasma preparation, the results of research on bums are controversial. OBJECTIVE: To systematically evaluate the effectiveness of platelet-rich plasma in the repair of bum wounds. METHODS: A computer-based online search of CNKI, VIP, WanFang, CBMdisc, PubMed, Embase, Cochrane Library, Web of Science databases to retrieve randomized controlled trials regarding platelet-rich plasma repair of bum wounds. In the treatment group, platelet-rich plasma therapy or platelet-rich plasma therapy combined with conventional or other therapies were used. In the control group, conventional therapy, other therapies, or placebo treatment were used. After literature screening, information extraction and quality evaluation, Review Manager 5.3 software was used for meta analysis. RESULTS AND CONCLUSION: Eleven articles were included, involving 837 patients consisting of 420 patients in the treatment group and 417 patients in the control group. Meta analysis results revealed that the wound healing rate in the treatment group was significantly higher than that in the control group [OR=12.61, 95%C/ (6.93, 18.29), P < 0.000 1]. Wound healing time in the treatment group was significantly shorter than that in the control group [OR=-4.64, 95%C/ (-6.21, -3.06), P < 0.000 01]. The number of layers of gauze soaked by dressing [OR=-4.01, 95%C/ (-4.91, -3.11), P< 0.000 01], the times of changing inner gauze [OR=-3.79, 95%C/ (-5.33, -2.26), P < 0.000 01, and the times of dressing change on wound surface [OR=-3.41, 95%C/ (-5.93, -0.88), P=0.008) in the treatment group were significantly less than those in the control group. The positive rate of bacterial culture in wound [OR=0.46, 95%C/ (0.22, 0.94), P=0.03] and the incidence of inflammatory reaction in wound [OR=0.30, 95%C/ (0.17, 0.56), P=0.000 1) in the treatment group were significantly lower than those in the control group. The results suggested that platelet-rich plasma can increase the wound healing rate, shorten wound healing time, reduce the number of layers of gauze soaked by dressing, the times of changing inner gauze, and the times of dressing change on wound surface, and lower the positive rate of bacterial culture and the incidence of inflammatory reaction in wound. [ABSTRACT FROM AUTHOR]

BACKGROUND: Short hip arthroplasty has the characteristics of less trauma, stable prosthesis, biomechanics and better bone retention. However, short-stem prosthesis is not widely used in hip arthroplasty at present, and the specific benefits of the population are still unclear. OBJECTIVE: To evaluate the efficacy and safety of long- and short-stem hip arthroplasty for treating femoral head necrosis. METHODS: Clinical randomized controlled trials of long-and short-stem hip arthroplasty were collected from PubMed database, Embese database, Medline database, Web of Science database and Cochrane library database. RevMan 5.3 software was used for meta-analysis of studies that met the inclusion criteria. RESULTS AND CONCLUSION: (1) Nine randomized controlled trials were involved in this study. 747 patients were divided into two groups: 383 long-stem hips and 364 short-stem hips. (2) Meta-analysis showed that hip Harris score was higher in the short-stem hip group than in the long-stem hip group at 6 months and more after surgery [MD=5.74, 95%CI(3.20, 8.27), P< 0.05; MD=4.16, 95%CI(2.36, 5.97), P < 0.05]. WOMAN index score was significantly improved in the short-stem hip group compared with the long-stem hip group after surgery [MD=10.37, 95%CI(5. 71, 15.03), P < 0.05]. NRS score for hip pain was significantly improved in the short-stem hip group compared with the long-stem hip group after surgery [MD=0.54, 95% CI{0.18, 0.90), P < 0.01 ]. There was no significant difference in incision infection, dislocation, unequal length of lower limbs and loosening of prosthesis between the two groups compared with bone mineral density at 6 months and over 6 months after operation [OR=0.40, 95%CI(0.13, 1.22), P > 0.05; MD=-0.02, 95%CI(-0.08, 0.03), P > 0.05; MD=-0.10, 95%CI(-0.16, 0.04 ), P > 0.05]. (3) These results indicated that short-stem hip arthroplasty is an effective method for the treatment of femoral head necrosis. It can relieve pain, restore joint function as soon as possible and improve surgical effect, especially for young patients with better bone. [ABSTRACT FROM AUTHOR]