Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2014
Comparative StudyCan Internet information on vertebroplasty be a reliable means of patient self-education?
Studies of the quality and accuracy of health and medical information available on the Internet have shown that many sources provide inadequate information. However, to our knowledge, there are no published studies analyzing the quality of information available online regarding vertebroplasty. Because this has been a high-volume procedure with highly debated efficacy, it is critical that patients receive complete, accurate, and well-balanced information before deciding a treatment course. Additionally, few studies have evaluated the merit of academic site authorship or site certification on information quality, but some studies have used measurements of quality that are based primarily on subjective criteria or information accuracy rather than information completeness. ⋯ Level IV, economic and decision analyses. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Observational StudyBurden incurred by patients and their caregivers after outpatient surgery: a prospective observational study.
The burden of patients and their caregivers after outpatient surgery has not been fully examined. The number of outpatient surgeries has dramatically increased in the last several years, particularly in the orthopaedic sector. Patients undergoing outpatient orthopaedic procedures may be expected to have more postdischarge pain than those undergoing nonorthopaedic outpatient procedures. In light of this, assessment of patient and caregiver expectations and actual burden after discharge is of importance. ⋯ Level II, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Continuous femoral nerve block using 0.125% bupivacaine does not prevent early ambulation after total knee arthroplasty.
Continuous femoral nerve block has been shown to decrease opioid use, improve postoperative pain scores, and decrease length of stay. However, several studies have raised the concern that continuous femoral nerve block may delay patient ambulation and increase the risk of falls during the postoperative period. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Topical tranexamic acid reduces blood loss and transfusion rates associated with primary total hip arthroplasty.
Systemic tranexamic acid can decrease blood loss and rates of transfusion in patients undergoing total hip arthroplasty (THA). However, the efficacy of topical tranexamic acid in THA has only recently been characterized in a small number of studies. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Fewer postoperative fevers: an unexpected benefit of multimodal pain management?
Elevated temperatures after total joint arthroplasty (TJA) are common and can be a source of anxiety both for the patient and the surgical team. Although such fevers rarely are caused by acute infection, many patients are subjected to extensive testing for elevated body temperature after surgery. We recently implemented a multimodal pain management regimen for TJA, which includes acetaminophen, pregabalin, and celecoxib or toradol, and because some of these medications have antipyrexic properties, it was speculated that this protocol might influence the frequency of postoperative pyrexia. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.