The Orthopedic clinics of North America
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Marked blood loss during lower extremity total joint arthroplasties may lead to higher rates of transfusion, which may negatively affect surgical outcomes and yield greater complication rates. It is therefore ideal to identify factors that may increase the likelihood of blood loss, so they can be modified. From this review, it can be concluded that preoperative anemia, older age, multiple comorbidities, increased operative time, and use of postoperative anticoagulation may lead to higher blood loss and transfusion rates, although the influence of other factors remains controversial.
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Orthop. Clin. North Am. · Oct 2015
ReviewPercutaneous Sacroiliac Screw Fixation of the Posterior Pelvic Ring.
Percutaneous sacroiliac (SI) screw fixation is indicated for unstable posterior pelvic ring injuries, sacral fractures, and SI joint dislocations. This article provides a review of indications and contraindications, preoperative planning, imaging techniques and relevant anatomy, surgical technique, complications and their management, and outcomes after SI screw insertion.
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Orthop. Clin. North Am. · Oct 2015
ReviewTraumatic Knee Dislocations: Evaluation, Management, and Surgical Treatment.
Knee dislocations are catastrophic injuries that demand emergent evaluation and often require a multidisciplinary approach. Long-term outcome studies are relatively scarce secondary to the variability in any given study population and the wide variety of injury patterns between knee dislocations. Multiple controversies exist with regard to outcomes using various treatment methods (early vs late intervention, graft selection, repair vs reconstruction of medial and lateral structures, rehabilitation regimens). Careful clinical evaluation is essential when knee dislocation is suspected.
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Orthop. Clin. North Am. · Oct 2015
ReviewLiposomal Bupivacaine: A Comparative Study of More Than 1000 Total Joint Arthroplasty Cases.
Pain after total joint arthroplasty (TJA) can be severe and difficult to control. A single-dose local analgesic delivers bupivacaine in a liposomal time-release platform. ⋯ Pain scores were significantly lower for patients in the Post group for both hip and knee procedures. A large series of patients who had TJA experienced pain relief after the introduction of liposomal bupivacaine as part of an established multimodal protocol.