The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2018
Comparative StudyOne Dose of Intravenous Tranexamic Acid Is Equivalent to Two Doses in Total Hip and Knee Arthroplasty.
Tranexamic acid (TXA) helps to prevent excessive blood loss during total hip arthroplasty (THA) and total knee arthroplasty (TKA), but the most efficacious dosing protocol has not been ascertained. The purpose of this study was to identify whether 1 dose of intravenous TXA is equivalent to 2 doses for reducing blood loss and transfusion rates following THA and TKA without an increase in complications. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jul 2018
Comparative Study Observational StudyTrabecular Metal Versus Non-Trabecular Metal Acetabular Components and the Risk of Re-Revision Following Revision Total Hip Arthroplasty: A Propensity Score-Matched Study from the National Joint Registry for England and Wales.
Studies have suggested that Trabecular Metal (TM)-coated acetabular components may reduce implant failure following revision total hip arthroplasty. However, these studies have predominantly been limited to small, single-center cohorts, with many lacking a comparator group. Using National Joint Registry data from England and Wales, we compared re-revision rates following revision total hip arthroplasty between TM and non-TM-coated acetabular components from 1 manufacturer. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2018
Comparison of Fixation Techniques for Acetabular Fractures Involving the Anterior Column with Disruption of the Quadrilateral Plate: A Biomechanical Study.
In elderly patients who have sustained an acetabular fracture involving disruption of the quadrilateral plate (QLP), postoperative loading of the joint beyond the level of partial weight-bearing can result in medial redisplacement of the QLP. The purpose of this biomechanical study was to compare the performances of 4 different fixation constructs intended to prevent medial redisplacement of the QLP. ⋯ Redisplacement of the QLP resulting in an incongruency of the hip joint has been associated with poor long-term outcomes. Within the constraints of this study, periarticular long screws were superior to infrapectineal buttress plates in preventing medial redisplacement of the QLP.
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J Bone Joint Surg Am · Jun 2018
A Locked Intraosseous Nail for Transverse Patellar Fractures: A Biomechanical Comparison with Tension Band Wiring Through Cannulated Screws.
Displaced transverse patellar fractures require open reduction and internal fixation. State-of-the-art stabilization techniques are tension band wiring (TBW) using Kirschner wires or cannulated screws. These techniques are associated with high rates of secondary fracture displacement, implant migration, implant prominence, wound-healing disturbances, and the need for implant removal. Recently, a locked intraosseous patellar nail prototype was developed. The aim of the present study was to investigate the biomechanical performance of this nail compared with TBW using cannulated screws. ⋯ A locked patellar nail for transverse patellar fractures achieved a stable osteosynthetic construct that may reduce hardware-associated complications because of its intraosseous positioning.
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J Bone Joint Surg Am · Jun 2018
Inability of Older Adult Patients with Hip Fracture to Maintain Postoperative Weight-Bearing Restrictions.
For elderly trauma patients, a basic goal is early mobilization, as immobilization can trigger various complications, such as venous thromboembolism, pneumonia, urinary tract infections, and pressure ulcers. Although partial weight-bearing has been shown to significantly increase mortality compared with unrestricted weight-bearing, it remains a frequent recommendation of aftercare following lower-extremity fracture fixation. ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.