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Daniel – Emil Albu, Monica Copotoiu, Răzvan Melinte, Tiberiu Băţagă and Sanda-Maria Copotoiu

Abstract

Background: The main target after successful AnteriorCruciate Ligament (ACL) reconstruction is early rehabilitation. New options such as PRP (platelet rich plasma) may improve clinical outcomes.

Objective: The aim of our study was to evaluate two consecutive series of patients who underwent ACL reconstruction, one with PRP treatment and one without it.

Material and method: Two groups of consecutive patients underwent arthroscopic ACL reconstruction, using the SemiT and BPTB techniques. Postoperatively all patients included in this study followed the same standardized rehabilitation protocol. In addition, patients in the first group received three intraarticular PRP injections as auxiliary therapy. Injections were performed at week two, four and six. The patients were evaluated at enrolment and every four and twelve weeks using the Tegner Lysholm Knee Scoring Scale (Scoring Scale: poor <65/ fair 65-83 / good 84-90 / excellent > 90). Each patient was operated on and evaluated afterwards by the same team of surgeons.

Results: At 12 weeks interval, Group A had a higher mean clinical score than Group B (94.67 vs 92.50) although marginally not statistically significant (p=0.0503, 95% CI: −4.336 to 0.002911). Regarding pain in patients from Group A compared with patients from Group B, we saw a statistically significant difference at 4 weeks interval (16.90 vs. 18.89, p=0.0370, 95% CI: 0.1260 to 3.842) and no significant difference at 12 weeks interval (21.19 vs. 21.94, p=0.3744, 95%CI: −0.9452 to 2.453). In terms of swelling points scored between the two groups, there was no statistically significant difference at 4 week interval (5.048 vs. 4.00, p=0.1979, 95% CI: −2.667 to 0.5714) but there is a significant difference in favor of patients from Group A at 12 weeks interval (8.475 vs. 5.556, p=0.0002, 95% CI: −4.323 to −1.159).

Conclusions: In the short term, the local treatment showed improvement on the overall clinical status of the patients (less pain, improved mobility, less swelling) undergoing rehabilitation after ACL reconstruction, although further studies are required.

Open access

Ioana-Aurița Albu-Stan, Daniel-Emil Albu, Diana Cerghizan, Lia Yero Eremie, Kinga Jánosi, Monica Baloș and Constantin Copotoiu

Abstract

Osteonecrosis of the jaws is a complication after treatment with antiresorptive drugs. Bisphosphonates (BPs) are widely used to treat conditions with bone metastases of malignant tumors such as multiple myeloma, breast cancer, prostatic cancer, as well as hypercalcemia of malignancy, osteoporosis, Paget’s disease, and osteogenesis imperfecta. Denosumab is an antiresorptive agent that is used for the treatment of osteoporosis or metastatic bone diseases. These antiresorptive agents improve the quality of life of patients by increasing strength and bone mineral density, and reducing the risk of bone fractures. More than a decade had passed since the first publication of this pathology, and the occurrence of the disease, its pathophysiology, and proper treatment methods are still not fully elucidated. Prevention is critical in medication-related osteonecrosis of the jaw, because the treatment is difficult, and there are no universally accepted treatment protocols. There is an accepted approach of palliation of symptoms and controlling the associated infections. Treatment may follow one of three procedures: conservative management of pain, conservative or extensive (segmental) surgery, depending on the disease stage.

Open access

Daniel Emil Albu, Monica Copotoiu, Peter Szmuk and Sanda-Maria Copotoiu

Open access

Daniel–Emil Albu, Copotoiu Monica, Jeremias Cristina, Susca Mihaela, Melinte Răzvan, Băţagă Tiberiu and Copotoiu Sanda-Maria

Abstract

Background: The main target of the structural damage in osteoarthritisis the hyaline cartilage. New options such as PRP (platelet rich plasma) may cause structural improvement of the cartilage.

Objective: The aim of our study was to evaluate the evolution of the patients with knee osteoarthritis on PRP treatment.

Material and method: The patients with osteoarthritis were evaluated at enrolment and every three months by ultrasound knee ecography. A semi-quantitative knee ultrasound score was applied to monitor changes before and after the treatment. The score was composed by the presence of the following: bursitis (1 point), hypoechogenic changes at the level of the hyaline cartilage in the anterior transversal window (1 point), asymmetrical narrowing of the cartilage (1 point), the involvement of the medial cartilage in the longitudinal approach (1 point), the involvement of lateral cartilage in the longitudinal approach (1 point) and the presence of step up lesions – osteophytes (1 point The evaluation was performed independently by two separate physicians. Another ultrasound - trained doctor was analysing all the images.

Results: Twenty - nine patients were included in our study; with one patient excluded due to masive bursitis. No differences were found concerning the pathological findings between the first two evaluators (p: 0.1250). So far, only nine patients have been evaluated at three months, and we were unable to find any improvements or worsening concerning the ultrasound alterations (p: 0.0625). The ultrasound lack of modifications was not correlated with the functional status of the subjects.

Conclusions: In the short term, the local treatment showed no improvement on structural damage, but it improved the overall status of the patients (less pain, improved mobility, a better quality of life).