The Journal of arthroplasty
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The authors experienced an unusual case of a patient with a complex tear of the lateral meniscus and adjacent lateral femoral condyle cartilage injury in the contralateral compartment by retained cement, possibly located at the posteromedial side of the medial tibial component after unicondylar knee arthroplasty. Arthroscopic partial meniscectomy and cartilage microfracture were successfully performed. Two small cement fragments were removed from the posterolateral compartment. A sharp pain in the lateral side disappeared postoperatively and posterior knee pain was much reduced.
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Comparative Study
A new tourniquet system that determines pressures in synchrony with systolic blood pressure in total knee arthroplasty.
This study reports the comparison of the clinical use of a new tourniquet system for total knee arthroplasty that can determine its pressure in synchrony with systolic blood pressure (SBP) with the conventional that keeps the initial setting pressure. We prospectively applied the additional pressure of 100 mm Hg based on the SBP recorded before skin incision to consecutive 72 procedures (conventional, initial 36; new, following 36). Six knees with the conventional and none of 5 with the new showed oozing blood in surgical field after sharp rise in SBP. Based on no statistically significant differences of the perioperative blood loss without any tourniquet-related postoperative complications in both groups, the new system seemed to be a practical device especially for controlling a bloodless surgical field.
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Total joint arthroplasty (TJA) is categorized as a major risk factor for thromboembolic complications. The importance of hypoxemia during the postoperative period is subject of controversy. This prospective study elucidates the incidence and etiology of hypoxemia after TJA. ⋯ These diagnoses included pulmonary embolism, pulmonary edema, and pneumonia. Tachypnea was the only independent factor associated with pulmonary embolism. Our study presents the incidence and etiology of hypoxemia after TJA, and we recommend a heightened appreciation for the hypoxemic patient.