The Journal of arthroplasty
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Improved pain management techniques and accelerated rehabilitation programs are revolutionizing our patients' postoperative experience after total hip and knee arthroplasty. The process involves regional anesthesia with multimodal pain control using local periarticular injections in combination with enhanced patient education and accelerated rehabilitation provided by a dedicated team of surgeons, physicians, anesthesiologists, physician assistants, physical therapists, and social workers. ⋯ Although this is not always the case, it was unheard of in prior years. It is our hope that future research into this area will make painful, difficult recoveries after total hip arthroplasty and total knee arthroplasty a distant memory.
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In the last 10 years, resurfacing hip arthroplasty has become a popular option again for treating hip disorders in younger, active patients in some parts of the world. We report the Australian experience with this operation based on the Australian National Joint Replacement Registry and the literature available on the Australian experience in Resurfacing.
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Optimizing the operating room environment is necessary to minimize the prevalence of arthroplasty infection. Reduction of bacterial contamination in the operating room should be a primary focus of all members of the operating room team. ⋯ The purpose of this review is to highlight important considerations for optimizing the operating room environment. These principles should be actively promoted by orthopedic surgeons in their operating rooms as part of a comprehensive approach to minimizing arthroplasty infection.
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Review Case Reports
Massive retroperitoneal hematoma during enoxaparin treatment of pulmonary embolism after primary total hip arthroplasty: case reports and review of the literature.
In light of the increasing use of enoxaparin for both prophylaxis and treatment of thromboembolic disease, the number of potential complications from this anticoagulant will also continue to increase. This article presents the first case of massive retroperitoneal hematoma during enoxaparin treatment of pulmonary embolism after a primary total hip arthroplasty and discusses several unique sequelae of the retroperitoneal hematoma. Retroperitoneal hematomas are often fatal, and treatment involves aggressive fluid resuscitation with possible surgical decompression.