Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyUnicompartmental versus total knee arthroplasty database analysis: is there a winner?
TKA and unicompartmental knee arthroplasty (UKA) are both utilized to treat unicompartmental knee arthrosis. While some surgeons assume UKA provides better function than TKA, this assumption is based on greater final outcome scores rather than on change in scores and many patients with UKA have higher preoperative scores. ⋯ While patients with UKA had higher pre- and postoperative scores than patients with TKA, the changes in scores were similar in both groups and survival appeared higher in patients with TKA.
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Clin. Orthop. Relat. Res. · Jan 2012
Incidence of deep vein thrombosis and pulmonary embolism after Achilles tendon rupture.
The use of venous thromboembolism prophylaxis after an Achilles rupture is controversial. The rates of reported deep vein thrombosis (DVT) range from 6.3% to 34%. There is no agreement regarding prophylactic therapy after an Achilles tendon rupture. ⋯ We found the overall incidence of symptomatic DVT and PE to be low after an Achilles tendon rupture and believe routine use of anticoagulation might be unwarranted.
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyPatient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA.
The impact of specific baseline comorbid conditions on the relative risk of postoperative mortality and periprosthetic joint infection (PJI) in elderly patients undergoing TKA has not been well defined. ⋯ We believe this information important when counseling elderly patients regarding the risks of mortality and PJI after TKA and risk-adjusting publicly reported TKA patient outcomes.
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyPlatelet-rich plasma does not reduce blood loss or pain or improve range of motion after TKA.
Numerous reports suggest the application of platelet-rich plasma (PRP) during TKA may decrease postoperative bleeding. Because excessive bleeding can increase postoperative pain and inflammation, use of PRP also reportedly decreases the need for narcotics and increases speed of recovery after TKA. Because previous investigations of PRP and TKA reflect a weak level of medical evidence, we sought to confirm these findings. ⋯ We found no clinically important differences in patients who received an intraoperative application of PRP compared with patients who did not receive PRP and therefore could not confirm the findings of previous studies.
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyPreoperative patient education reduces in-hospital falls after total knee arthroplasty.
Inpatient hospital falls after orthopaedic surgery represent a major problem, with rates of about one to three falls per 1000 patient days. These falls result in substantial morbidity for the patient and liability for the institution. ⋯ Inpatient falls after TKA may be associated with major complications. Our preoperative patient education reduced these falls and is now mandatory for patients undergoing TKA at our institution.