The Journal of arthroplasty
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Frailty and disability from arthritis are closely intertwined and little is known about the impact of frailty on total hip arthroplasty (THA) outcomes. We hypothesized that higher preoperative frailty is associated with more adverse events following THA. ⋯ A higher preoperative frailty index is associated with increased mortality and perioperative complications following primary and revision THA. The proposed frailty deficit index provides clinically important information for healthcare providers to use when counseling patients prior to decision for surgery.
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Assessing patients' functional outcomes following total hip arthroplasty with traditional scoring systems is limited by their ceiling effects. The Forgotten Joint Score (FJS) has been suggested as a more discriminating option. The actual score in the FJS which constitutes a "forgotten joint," however, has not been defined. The emerging concept of joint perception led to the development of the Patient's Joint Perception question (PJP) to assess the patient's opinion of their prosthetic joint. ⋯ A forgotten hip perception corresponds to an FJS >93. In 20%-30% of the cases, the WOMAC and FJS failed to identify the forgotten joint, or reached the maximum score when the patients did not feel their hip was natural. The PJP is a simple and reliable tool that enables identification of patients who feel replaced hip is natural.
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While the 11-factor modified frailty index (mFI) has been shown to predict adverse outcomes in patients undergoing total joint arthroplasty, the 5-factor index has not been evaluated in this patient population. The goal of this study was to evaluate the utility of the mFI-5 as a predictor of morbidity and mortality in patients undergoing primary total hip and knee arthroplasty. ⋯ III.
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This study investigated the effects of dronabinol on pain, nausea, and length of stay following total joint arthroplasty (TJA). ⋯ These findings suggest that further investigation into the role of cannabinoid medications for non-opioid pain control in the post-arthroplasty patient may hold merit.
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Observational Study
The Role of Perioperative Statin Use in the Prevention of Delirium After Total Knee Replacement Under Spinal Anesthesia.
The relationship between statin use and incidence of postoperative delirium (POD) is controversial. We investigated the association between perioperative statin use and occurrence of delirium after total knee arthroplasty (TKA) under spinal anesthesia. ⋯ Continuous perioperative statin use may be associated with a significantly lower risk of delirium after TKA under spinal anesthesia; simvastatin was the most effective statin for POD prevention.