Orthopedics
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The results of TKA during the past two decades have been reliable and favorable. While success rates are high, some patients experience pain and impaired function. This clinical scenario can be frustrating to both the patient and the surgeon who is accustomed to good outcomes. ⋯ Laboratory tests and imaging studies can provide additional evidence supporting a particular diagnosis. Once the etiology has been established, symptomatic relief may be achieved with appropriate treatment including revision TKA. However, revision TKA that is performed for unexplained pain is associated with a low probability of success.
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Comparative Study
Accuracy of intra-articular injection of the glenohumeral joint: a cadaveric study.
Intra-articular glenohumeral injections are an important part of orthopedic practices for both therapeutic and diagnostic purposes. Forty human cadaver shoulders were injected, 20 anteriorly and 20 posteriorly, to assess the accuracy of injections placed in the glenohumeral joint. After the needle was placed, 1 cc of gadolinium was injected into the joint to determine accuracy of position. ⋯ The anterior approach had an 80% accuracy rate and .75 positive predictive value. The posterior approach had a 50% accuracy rate and a .67 positive predictive value. Anterior injections produce a higher rate of accuracy than posterior injections.
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Randomized Controlled Trial
Does aprotinin reduce blood loss in total hip arthroplasty?
This prospective randomized study examined the effects of aprotinin during total hip arthroplasty (THA). Fifty patients who were enrolled in the study received aprotinin or normal saline. Mean intraoperative blood loss was reduced from 1496 mL in the control group to 1073 mL in the aprotinin group. The mean transfusion unit was 1.56 in the aprotinin group and 3.8 in the control group.