The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Dec 2017
Comparative StudySame-Day Discharge Compared with Inpatient Hospitalization Following Hip and Knee Arthroplasty.
Discharge from the hospital on the day of (same-day) hip and knee arthroplasties has become more common; however, to our knowledge, few studies have compared morbidity between same-day and inpatient surgical procedures. The aims of this study were to compare matched cohorts of patients who underwent same-day and inpatient hip or knee arthroplasty in terms of postoperative complications and 30-day readmission rates. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Dec 2017
Direct Anterior Hip Replacement Does Not Pose Undue Radiation Exposure Risk to the Patient or Surgeon.
The fluoroscopically assisted direct anterior approach for total hip arthroplasty has gained interest in recent years. One of the perceived advantages is the use of fluoroscopy to aid in the positioning of implants. The purpose of this study was to measure the radiation entrance surface dose to anatomically important areas of both patients and surgeons during direct anterior approach total hip arthroplasty. ⋯ We believe this study to have clinical relevance because both patients and surgeons have evidence that utilization of fluoroscopy during direct anterior total hip replacement places both parties at a relatively low radiation exposure risk.
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J Bone Joint Surg Am · Nov 2017
Nationwide Analysis of Femoral Neck Fractures in Elderly Patients: A Receding Tide.
Geriatric femoral neck fractures are associated with substantial morbidity and medical cost. We evaluated the incidence and management trends of femoral neck fractures in recent years in the U.S. ⋯ This report identifies the changing trends in clinical practice in the treatment of geriatric femoral neck fractures in the U.S. Treating physicians should be aware of these trends, which include a decreasing national incidence of geriatric femoral neck fractures as well as an increase in the use of THA.
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J Bone Joint Surg Am · Nov 2017
Randomized Controlled TrialContinuous Posterior Lumbar Plexus Nerve Block Versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Total Hip Arthroplasty: A Three-Arm Randomized Clinical Trial.
Debate surrounds the issue of whether peripheral nerve blockade or periarticular infiltration (PAI) should be employed within a contemporary, comprehensive multimodal analgesia pathway for total hip arthroplasty. We hypothesized that patients treated with a continuous posterior lumbar plexus block (PNB) would report less pain and consume less opioid medication than those treated with PAI. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.