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OBJECTIVE: Patient-specific templates promises to be able to increase alignment while decreasing operative time, increasing patient throughput, decreasing instrumentation, reducing risk of fat embolism and intraoperative bleeding, decreasing tissue loss, shortening recovery, reducing post-operative pain and decreasing incidence of infection. However, multiple studies have shown conflicting results regarding these potential benefits. This study serves to critically evaluate the potential advantages and disadvantages of using a patient-specific templating technique through a single-surgeon study. METHODS: All patients who underwent primary total knee arthroplasty (TKA) for osteoarthritis of the knee using TruMatch® Personal Solutions total knee replacement by a single surgeon were identified. An age-, gender-, side-, diagnosis- and surgeon-matched cohort who underwent conventional primary TKAs was randomly identified for comparison. RESULTS: The average distal medial femur (p

Purpose: Concerning the ongoing debate on the effects of continuing aspirin therapy on blood loss in knee arthroplasty, we conducted a retrospective investigation to test the hypothesis that continuation of aspirin prior total knee arthroplasty (TKA) will not cause more blood loss. Methods: From a database of patients who underwent unilateral TKA between 2011 and 2016, we identified two groups: the aspirin group (patients continued aspirin during perioperative period) and the nonaspirin group (patients had no current or recent history of aspirin usage). We extracted and compared patient demographic information, comorbidity index, baseline serum hemoglobin (Hb), and creatinine level between the two groups. We also compared our primary outcomes, including the total blood loss, transfusion requirement, and length of hospitalization between the two groups. A multivariate logistic regression for analyzing the risk factors of requiring transfusion was performed. Results: We found that apart from preoperative serum creatinine level, there was no difference in the baseline Hb level, perioperative change in Hb, total blood loss, or length of hospitalization between the two groups. The percentage of transfusion utilization was also comparable between the two groups. Our regression analysis shows that the risk of requiring transfusion after TKA is not significantly associated with patients taking aspirin therapy before operation. Conclusion: Patients who underwent TKA with continuation of low-dose aspirin did not result in more blood loss. Current blood loss management has provided sufficient reduction of blood loss to accommodate aspirin therapy perioperatively. We suggest that it is safe to continue aspirin prior to TKA.

Background: A comparative cross-sectional study involving oral cancer patients and healthy individuals was designed to investigate associations between retinol, alpha-tocopherol and beta-carotene with the risk of oral cancer. Materials and Methods: This study included a total of 240 matched cases and controls where subjects were selected from the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). Retinol, alpha-tocopherol and beta-carotene levels and intake were examined by high-performance liquid chromatography (HPLC) and food frequency questionnaire (FFQ) respectively. Results: It was found that results from the two methods applied did not correlate, so that further analysis was done using the HPLC method utilising blood serum. Serum levels of retinol and alpha-tocopherol among cases (0.177 +/- 0.081, 1.649 +/- 1.670 mu g/ml) were significantly lower than in controls (0.264 +/- 0.137, 3.225 +/- 2.054 mu g/ml) (p

Objective: To determine the prevalence of facial fractures in children under 15 years of age in Malaysia. Patients andMethods: A prospective study was conducted of the pattern of presentation and treatment of facial bone fractures in paediatric patients under the age of 15 years treated at 23 major government hospitals of the Ministry of Health, Malaysia, from 1 June 2002 to 31 May 2003. Results: 113 cases of facial fractures in children were recorded. The male-to-female ratio was 3.2:1.0, with Malays accounting for 80% of all cases. No patient below 1 year of age was reported and 15-year-olds represented the single largest group (32.7%). Motor vehicle accidents were the major cause (83%). The mandible was the most common bone to fracture (65%), with the mandibular body being the commonest fracture site. Midface fractures occurred in 25% with the zygoma being the commonest bone involved. Only 10% of cases involved both jaws. Conclusion: As the major cause of fractured facial bones in the paediatric population is motor vehicle accidents, preventive legislation, improved road construction measures, and vehicle safety modifications would be helpful.

Between 1992 and 2002, 29 patients with osteochondritis dissecans of the talus underwent arthroscopic debridement. The average duration of symptoms pre-operatively was 30.5 months. They were followed up for an average of 57.5 months. There was a history of trauma in 77% of the ankles. A retrospective analysis was conducted using the radiographic staging of Berndt and Harty to classify the lesions. The grading of Berndt and Harty and the ankle-hindfoot score (AHS) of the AOFAS were used to assess the results of surgery. The average post-operative AHS was 93.5 points. Forty-five percent of the ankles were graded excellent, 48% good and 7% fair. No ankles were graded poor post-operatively. There was good correlation between the AHS and the grading of Berndt and Harty. There were no post-operative complications and all patients felt an improvement of their symptoms after surgery. The results of patients on follow-up for more than 5 years are similar to those on a shorter follow-up. The presence of a history of trauma did not affect the final outcome after surgery. Medial and lateral lesions had similar results after operation, as did those with a history of trauma and those without. The radiographic staging appeared to predict good outcome only in stage I lesions, although the difference was minimal. It did not appear to affect the final outcome after surgery for stages II–IV.